Basic Information
| Provider Information | |||||||||
| NPI: | 1558436733 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHSAN | ||||||||
| FirstName: | REHAAN | ||||||||
| MiddleName: | MUJTABA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ANSARI | ||||||||
| OtherFirstName: | MUJTABA | ||||||||
| OtherMiddleName: | AHSAN | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3998 FAIR RIDGE DR | ||||||||
| Address2: | STE 300 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220332921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037669737 | ||||||||
| FaxNumber: | 7037669725 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 HOSPITAL DR. | ||||||||
| Address2: | FAUQUIER HOSPITAL | ||||||||
| City: | WARRENTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403165000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2006 | ||||||||
| LastUpdateDate: | 12/26/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 0101231465 | VA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.