Healthcare Provider Details
I. General information
NPI: 1487117826
Provider Name (Legal Business Name): OMAR SHWAIKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/11/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US
IV. Provider business mailing address
6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US
V. Phone/Fax
- Phone: 202-537-4686
- Fax:
- Phone: 410-933-6423
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD600006162 |
| License Number State | DC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | ME175877 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: