Provider Demographics
NPI:1366138216
Name:HASIB, MD ABDUL
Entity type:Individual
Prefix:MR
First Name:MD ABDUL
Middle Name:
Last Name:HASIB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21263 THATCHER TER APT 303
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4745
Mailing Address - Country:US
Mailing Address - Phone:571-774-0924
Mailing Address - Fax:
Practice Address - Street 1:21263 THATCHER TER APT 303
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4745
Practice Address - Country:US
Practice Address - Phone:571-774-0924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA713500343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)