Provider Demographics
NPI: | 1760826614 |
---|---|
Name: | MUSA, ABDULLAHI (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ABDULLAHI |
Middle Name: | |
Last Name: | MUSA |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | ABDULLAHI |
Other - Middle Name: | MOHAMAD MUKHTAR |
Other - Last Name: | MUSA |
Other - Suffix: | |
Other - Last Name Type: | Other Name |
Other - Credentials: | |
Mailing Address - Street 1: | 220 CAMPUS BLVD STE 320 |
Mailing Address - Street 2: | |
Mailing Address - City: | WINCHESTER |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22601-2889 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 540-536-5100 |
Mailing Address - Fax: | 540-536-0235 |
Practice Address - Street 1: | 1870 AMHERST ST STE 3D |
Practice Address - Street 2: | |
Practice Address - City: | WINCHESTER |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22601-2873 |
Practice Address - Country: | US |
Practice Address - Phone: | 540-536-5840 |
Practice Address - Fax: | 540-536-5841 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2013-04-22 |
Last Update Date: | 2025-04-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0101260579 | 207RG0100X, 208M00000X |
AR | E-16472 | 207R00000X, 207RG0100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist |