1295733384 NPI number — FIRAS AL-KAWAS MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295733384 NPI number — FIRAS AL-KAWAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL-KAWAS
Provider First Name:
FIRAS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295733384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9910 FRANKLIN SQUARE DR STE 2110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21236-4902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-933-6423
Provider Business Mailing Address Fax Number:
410-933-1390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5215 LOUGHBORO RD NW STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-2626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-660-5555
Provider Business Practice Location Address Fax Number:
202-660-6103
Provider Enumeration Date:
07/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  D24207 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: MD10342 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100014042 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 497021700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010502600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5839815 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".