Provider Demographics
NPI:1548038391
Name:ASCENT INTEGRATED MEDICINE INC
Entity type:Organization
Organization Name:ASCENT INTEGRATED MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADIYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-282-6904
Mailing Address - Street 1:3301 WOODBURN RD # 206
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1229
Mailing Address - Country:US
Mailing Address - Phone:703-282-6904
Mailing Address - Fax:703-538-6675
Practice Address - Street 1:3301 WOODBURN RD # 206
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1229
Practice Address - Country:US
Practice Address - Phone:703-538-5455
Practice Address - Fax:703-538-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty