MOHAMMAD SHAHIM FORMOLY CSA - NPI 1992104954 - Specialist/Technologist, Other in Fairfax, VA

Q: What is Mohammad Shahim Formoly's NPI number?

The NPI number for Mohammad Shahim Formoly is 1992104954. It was assigned to this individual provider in the NPPES registry on August 15, 2014.

Q: What is Mohammad Shahim Formoly's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other, specializing in Surgical Assistant, with taxonomy code 246ZC0007X.

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About Mohammad Shahim Formoly Csa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAMMAD SHAHIM FORMOLY CSA (NPI 1992104954) is an individual surgical assistant in Fairfax, Virginia, licensed in (4160) and active in the NPI registry since August 2014.

NPPES Registry Identity

NPI1992104954

Entity TypeIndividualMale

Primary Taxonomy246ZC0007X

Provider Legal NameMOHAMMAD SHAHIM FORMOLYCredential: CSA

Location Address12011 LEE JACKSON MEMORIAL HWY STE 501Fairfax, VA 22033

Mailing AddressPo Box 221135Chantilly, VA 20153-1135 · (703) 349-1379

Phone(703) 349-1379

Sole ProprietorYes

Enumeration DateAugust 15, 2014

Last NPPES UpdateSeptember 6, 20182 updates tracked since enumeration

✔ NPI 1992104954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, Other · Surgical AssistantTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code246ZC0007X

License✔ Licensed · 4160

Definition

A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.

12011 LEE JACKSON MEMORIAL HWY STE 501, Fairfax, VA 22033

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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FAIRFAX MEDICAL ASSOCIATES,LLC

Specialist/Technologist, Other (Surgical Assistant)