Provider Demographics
NPI:1356780928
Name:KHAFAGY, AYATALLAH M (MB BCH MSC MPH)
Entity type:Individual
Prefix:DR
First Name:AYATALLAH
Middle Name:M
Last Name:KHAFAGY
Suffix:
Gender:F
Credentials:MB BCH MSC MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 IRON BAR LN STE 219
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3614
Mailing Address - Country:US
Mailing Address - Phone:703-776-2745
Mailing Address - Fax:866-291-4915
Practice Address - Street 1:3600 JOSEPH SIEWICK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1709
Practice Address - Country:US
Practice Address - Phone:703-391-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD86121207V00000X
MA256714207V00000X
VA0101266029207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology