Individual provider · NPI-1

Dr. Tayseer Aldaghlas, M.D.

Family Medicine · Fairfax, VA

NPI number1427334747
StatusActive
Last updated in NPPESFeb 27, 2020

Details

NPI
1427334747
Entity type
Individual (NPI-1)
Name
Dr. Tayseer Aldaghlas
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 1, 2011
Certification date
Feb 27, 2020
Last updated
Feb 27, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine0101249887VAYes
208600000X Surgery0101249887VA

Practice location

10701 Main St
Fairfax, VA 22030-6904

Phone 703-855-1771

Mailing address

2776 S Arlington Mill Dr Unit 505
Arlington, VA 22206-3402

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