Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0401416868 | VA |
Y | 213EG0000X | General Practice | 0401416868 | VA |
NPI | 1003430851 |
---|---|
Provider Name | Hamzah Alghazali |
First Address | Great Falls, VA 22066-4239 |
Second Address | Tysons, VA 22182-3872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2020 |
Last Update Date | 07/06/2020 |