Individual provider · NPI-1

Dr. Hanibal Mahdi, MD

Internal Medicine · Vienna, VA

NPI number1891753406
StatusActive
Last updated in NPPESNov 14, 2023

Details

NPI
1891753406
Entity type
Individual (NPI-1)
Name
Dr. Hanibal Mahdi
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 3, 2006
Certification date
Nov 14, 2023
Last updated
Nov 14, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine0101056882VAYes
207P00000X Emergency Medicine0101056882VA
207PE0004X Emergency Medicine, Emergency Medical Services0101056882VA

Practice location

305 Maple Ave W Ste A
Vienna, VA 22180-4306

Phone 571-407-7004 · Fax 571-407-7092

Mailing address

305 Maple Ave W Ste A
Vienna, VA 22180-4306

Phone 571-407-7004 · Fax 571-407-7092

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