Healthcare Provider Details

I. General information

NPI: 1023458916
Provider Name (Legal Business Name): BILAL KHAN YOUSUFZAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW DEPT OF OPHTHALMOLOGY
WASHINGTON DC
20010-3017
US

IV. Provider business mailing address

110 IRVING ST NW DEPT OF OPHTHALMOLOGY
WASHINGTON DC
20010-3017
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-5658
  • Fax: 202-877-7743
Mailing address:
  • Phone: 202-877-5658
  • Fax: 202-877-7743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number006175
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: