Mahtab Mollajafar
Physician Assistant in Fairfax Station, VA. Individual provider (NPI-1).
NPI number1659836799
StatusActive
Last updated in NPPESOct 14, 2021
Details
- NPI
- 1659836799
- Entity type
- Individual (NPI-1)
- Name
- Mahtab Mollajafar
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 3, 2019
- Certification date
- Oct 14, 2021
- Last updated
- Oct 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0110007682 | VA | Yes |
Practice location
8212 Roseland DrFairfax Station, VA 22039-2534
Phone 703-507-9266
Mailing address
8212 Roseland DrFairfax Station, VA 22039-2534
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