Healthcare Provider Details

I. General information

NPI: 1164625273
Provider Name (Legal Business Name): ASHRAF SAUD HARAHSHEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

PO BOX 37215
BALTIMORE MD
21297-3215
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-2020
  • Fax: 202-476-5700
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number4301078447
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberD0067809
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: