Individual provider · Type 1 NPI

Mohammad Shahim Formoly, CSA

Surgical Assistant · Fairfax, VA

NPI number 1992104954 Active

Practice location

12011 Lee Jackson Memorial Hwy Ste 501
Fairfax, VA 22033

Call (703) 349-1379 Map

Mailing address

PO Box 221135
Chantilly, VA 20153-1135

Specialties and licenses

TaxonomyCodeLicense
Surgical Assistant Primary 246ZC0007X4160

Surgical Assistant: 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 h…

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About NPI 1992104954

Mohammad Shahim Formoly, CSA's National Provider Identifier is 1992104954, issued on Aug 15, 2014. The primary taxonomy on file is Surgical Assistant (246ZC0007X), and the practice location is in Fairfax, VA. The record was last updated on Sep 6, 2018.