MEDICARE: DR. FADI PHILIP NASRALLAH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	D0039747	MD

General Provider Information

NPI Number	:	1427055144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FADI PHILIP NASRALLAH M.D.

Provider Business Mailing Address
First Line	:	6410 ROCKLEDGE DR
Second Line	:	SUITE 400
City	:	BETHESDA
State	:	MD
Zip	:	20817-1842
Country	:	US
Telephone Number	:	301-530-5200
Fax Number	:	301-493-6577

Provider Business Practice Location Address
First Line	:	6720A ROCKLEDGE DR STE 200
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1888
Country	:	US
Telephone Number	:	301-530-5200
Fax Number	:	301-493-6577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	12/03/2019

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