Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 33631 | VA |
NPI | 1043299472 |
---|---|
Provider Name | George W Tawil |
First Address | Fairfax, VA 22030 |
Second Address | Alexandria, VA 22304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 11/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B50711 | (02) |