Provider Demographics
NPI:1992955777
Name:ELSAYED, SOHAIB S (MD)
Entity type:Individual
Prefix:
First Name:SOHAIB
Middle Name:S
Last Name:ELSAYED
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 1:46164 WESTLAKE DR UNIT 650513
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-8027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3481 N BEAUREGARD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1341
Practice Address - Country:US
Practice Address - Phone:571-290-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091115207Q00000X
MO2025003029207Q00000X
WV25796207Q00000X
VA0101246471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810027446Medicaid
WVWV4246B987OtherMEDICARE PTAN
VA1992955777Medicaid
MD346400800Medicaid
VAVVN774AMedicare PIN