Imam, Azhar

Imam, Azhar is an individual health care provider with primary practice located at 3930 Pender Dr Ste 350 , Fairfax VA 22030-0989. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Imam, Azhar can be contacted via phone (703) 865-8686.

Contact Information

Primary practice address
3930 Pender Dr Ste 350 Fairfax VA 22030-0989
Phone: (703) 865-8686
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 042814 Connecticut
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0101285977 Virginia

Profile Details

NPI number 1578516597
LBN Legal business name Imam, Azhar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Aug 12th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578516597 NPPES
Connecticut MEDICAID 001428144

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