Provider Demographics
NPI:1588869903
Name:OSMAN, TAHANIE (MD)
Entity type:Individual
Prefix:DR
First Name:TAHANIE
Middle Name:
Last Name:OSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAHANIE
Other - Middle Name:
Other - Last Name:ABU AHMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P O BOX 419402 SUITE A
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:540-741-4257
Mailing Address - Fax:
Practice Address - Street 1:12006 KILARNEY DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-7207
Practice Address - Country:US
Practice Address - Phone:540-786-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00975427Medicare PIN
VAVV3393AMedicare PIN
VA1588869903Medicaid