Provider Demographics
NPI:1124438874
Name:FAROOQ, TAMKEEN M (DO)
Entity type:Individual
Prefix:
First Name:TAMKEEN
Middle Name:M
Last Name:FAROOQ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6355 WALKER LN STE 500
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3251
Mailing Address - Country:US
Mailing Address - Phone:703-797-6970
Mailing Address - Fax:703-922-3479
Practice Address - Street 1:6355 WALKER LN STE 500
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3251
Practice Address - Country:US
Practice Address - Phone:703-797-6970
Practice Address - Fax:703-922-3479
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA273309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine