Basic Information
Provider Information
NPI: 1467934943
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAM
FirstName: ARFEEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 980257
Address2:  
City: RICHMOND
State: VA
PostalCode: 232980257
CountryCode: US
TelephoneNumber: 8048289783
FaxNumber:  
Practice Location
Address1: VCUHS DEPT OF ANES RESIDENCY, 980459
Address2: 1250 E. MARSHALL STREET
City: RICHMOND
State: VA
PostalCode: 232980459
CountryCode: US
TelephoneNumber: 8048280733
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2018
LastUpdateDate: 08/31/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X0116031903VAY193400000X SINGLE SPECIALTY GROUPStudent, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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