Healthcare Provider Details

I. General information

NPI: 1265991004
Provider Name (Legal Business Name): SHERENE WALEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERENE AGAMA MD

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NEW MEXICO AVE NW STE 220
WASHINGTON DC
20016-3627
US

IV. Provider business mailing address

3301 NEW MEXICO AVE NW STE 220
WASHINGTON DC
20016-3627
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-1180
  • Fax: 202-244-7410
Mailing address:
  • Phone: 202-537-1180
  • Fax: 202-244-7410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD200001403
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: