Provider Demographics
NPI:1386822617
Name:BUKHARI, KANEEZE-FATEMA ALTAFHUSEN (MD)
Entity type:Individual
Prefix:DR
First Name:KANEEZE-FATEMA
Middle Name:ALTAFHUSEN
Last Name:BUKHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 S KING ST STE F
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3916
Mailing Address - Country:US
Mailing Address - Phone:703-777-5222
Mailing Address - Fax:703-777-5144
Practice Address - Street 1:823 S KING ST STE F
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3916
Practice Address - Country:US
Practice Address - Phone:703-777-5222
Practice Address - Fax:703-777-5144
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002848208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics