1447258538 NPI number — NAHRAIN H ALZUBAIDI MD

Table of content: NAHRAIN H ALZUBAIDI MD (NPI 1447258538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447258538 NPI number — NAHRAIN H ALZUBAIDI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALZUBAIDI
Provider First Name:
NAHRAIN
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1447258538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4211 FAIRFAX CORNER EAST AVE
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22030-8623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-802-9600
Provider Business Mailing Address Fax Number:
703-802-9602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4211 FAIRFAX CORNER EAST AVE
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22030-8622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-802-9600
Provider Business Practice Location Address Fax Number:
703-802-9602
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: 207RE0101X , with the licence number:  33897 , 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: 5878845 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 034310100 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 460003745 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400157500 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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