| Tajammul Ehsan Md Pc | |
|
722 Grant St Ste. F Herndon VA 20170-4532 | |
| (703) 787-7638 | |
| (703) 787-7654 |
| Full Name | Tajammul Ehsan Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 722 Grant St, Herndon, Virginia |
| Authorized Official Name and Position | Tajammul Ehsan (PRESIDENT) |
| Authorized Official Contact | 7037877638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tajammul Ehsan Md Pc 722 Grant St Ste. F Herndon VA 20170-4532 Ph: (703) 787-7638 | Tajammul Ehsan Md Pc 722 Grant St Ste. F Herndon VA 20170-4532 Ph: (703) 787-7638 |
| NPI Number | 1689765760 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 2567625288 |
|---|---|
| Medicare Enrollment ID | O20120524000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689765760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 0101232388 (Virginia) | Primary |
| Provider Name | Tajammul Ehsan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760583397 PECOS PAC ID: 0446413165 Enrollment ID: I20120524000103 |
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