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Mohammed Ashiq Mannan

Internal Medicine

Allopathic & Osteopathic Physicians

3300 Gallows Rd, Department Of Medicine, Falls Church, VA 22042-3307

PECOS Enrollment

This provider is enrolled in PECOS as MOHAMMED MANNAN.

Based on the most recent information from CMS, provider Mohammed Ashiq Mannan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1699766469
Provider Type
Individual
Full Name
Mannan, Mohammed Ashiq
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
11/2/2005
Last Updated
10/17/2022

Contact Information

Practice Location

3300 Gallows Rd, Department Of Medicine, Falls Church, VA 22042-3307

(703) 776-3582

Unlisted Fax

Mailing Location

3300 Gallows Rd, Department Of Medicine, Falls Church, VA 22042-3307

(703) 776-3582

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 0101237447 Virginia
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 0101237447 Virginia

Provider Identifiers

ID	Description	Issuer
ID 232359401	Description Other	Issuer GREAT VALLEY HEALTH Pennsylvania

Mohammed Ashiq Mannan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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