Doctor Name: | DR. HAYSAM BAHO |
NPI Number: | 1710110366 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 0101246218 |
Business Practice Address: | 9548 Surveyor Ct Manassas, VA - 201104406 |
Business Phone Number: | 7033699090 |
Business Fax Number: | 7033929646 |
Mailing Address: | 19465 Deerfield Ave, Suite #310 LEESBURG |
State: | VA |
Postal Code: | 201761701 |
Phone Number: | 9493407273 |
Fax Number: | 7037244408 |
NPI Enumeration Date: | 08/31/2009 |
NPI Last Update Date: | 08/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0101246218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |