Healthcare Provider Details

I. General information

NPI: 1023704863
Provider Name (Legal Business Name): WAEL AZZAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDSTAR WASHINGTON HOSPITAL CENTER 110 IRVING ST. NW DEPT OF INTERNAL MEDICINE
WASHINGTON DC DC
20010
US

IV. Provider business mailing address

110 IRVING ST NW
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2835
  • Fax: 202-877-8288
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMTL600001747
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: