Provider Demographics
NPI:1275545196
Name:MURTAZA, SYED J (MD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:J
Last Name:MURTAZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:43575 WORLD WOODS CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4178
Mailing Address - Country:US
Mailing Address - Phone:540-316-2660
Mailing Address - Fax:
Practice Address - Street 1:493 BLACKWELL RD STE 317A
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2628
Practice Address - Country:US
Practice Address - Phone:540-316-2660
Practice Address - Fax:540-316-5001
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012382822084P0800X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275545196Medicaid
VA017619P82Medicare PIN