| Evergreen Neurology And Sleep Center | |
|
8609 Sudley Rd Ste 204 Manassas VA 20110-4500 | |
| (703) 348-7207 | |
| (703) 435-1844 |
| Full Name | Evergreen Neurology And Sleep Center |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 8609 Sudley Rd Ste 204, Manassas, Virginia |
| Authorized Official Name and Position | Ishtiaq Ahmad (CEO) |
| Authorized Official Contact | 7033899712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Neurology And Sleep Center 8609 Sudley Rd Ste 204 Manassas VA 20110-4500 Ph: (703) 348-7207 | Evergreen Neurology And Sleep Center 8609 Sudley Rd Ste 204 Manassas VA 20110-4500 Ph: (703) 348-7207 |
| NPI Number | 1750870556 |
|---|---|
| Provider Enumeration Date | 05/07/2018 |
| Last Update Date | 05/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750870556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101260753 (Virginia) | Primary |
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