Provider Demographics
NPI:1215060553
Name:AIJAZI, MAHMOOD GHAUS (MD)
Entity type:Individual
Prefix:DR
First Name:MAHMOOD
Middle Name:GHAUS
Last Name:AIJAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13426 ALFRED MILL CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3623
Mailing Address - Country:US
Mailing Address - Phone:571-203-9277
Mailing Address - Fax:
Practice Address - Street 1:1980 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:TYSONS CORNER
Practice Address - State:VA
Practice Address - Zip Code:22182-3913
Practice Address - Country:US
Practice Address - Phone:703-662-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232202207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology