Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0104001959 | VA |
NPI | 1386711869 |
---|---|
Provider Name | Dr. Waleed Mahmoud Abul-Hawa |
First Address | Alexandria, VA 22314-5301 |
Second Address | Alexandria, VA 22314-5301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 01/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
541901737 | TAX ID (01) | VA |
F0650001 | BCBS PROVIDER NUMBER (01) | VA |
U75100 | (02) | VA |