Mohammad Shahim Formoly, CSA
Mohammad Shahim Formoly, CSA is a Surgical Assistant in Fairfax, Virginia. Practices as a sole proprietor. Registered with an NPI since 2014.
- In the registry since
- 2014
Practice location Address checks out
12011 Lee Jackson Memorial Hwy Ste 501Fairfax, VA 22033
Phone: (703) 349-1379
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Specialties & licences
| Surgical Assistant (primary) | Taxonomy 246ZC0007X · Licence 4160 |
|---|
Record details
| NPI number | 1992104954 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CSA |
| Sole proprietor | Yes |
| NPI enumerated | August 15, 2014 |
| Last updated in NPPES | September 6, 2018 |
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