Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | D0058640 | MD |
NPI | 1366471948 |
---|---|
Provider Name | Dr. Mohammed Elkousy |
First Address | Reston, VA 20190-3219 |
Second Address | Reston, VA 20190-3219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 07/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010241871 | (05) | VA |
512008000 | (05) | MD |
H73342 | (02) | DE |