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1235833831
IJAZ RYAN RAFIQ MOHAMED
ROANOKE, VA
NPI
1235833831
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: VA 390200000X)
Enumeration Date
2023-03-28
Last Update Date
2023-03-28
Business Address
IJAZ RYAN RAFIQ MOHAMED DO
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014-1838
Phone number: 540-981-7000
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Mailing Address
IJAZ RYAN RAFIQ MOHAMED DO
4917 ELLIS LN
ELLICOTT CITY, MD 21043-6852
Phone number: 410-599-8728
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