Healthcare Provider Details

I. General information

NPI: 1851889877
Provider Name (Legal Business Name): FAREED RAJACK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGINA AVENUE N.W. HOWARD UNIVERSITY HOSPITAL
WASHINGTON DC
20060
US

IV. Provider business mailing address

2041 GEORGINA AVENUE N.W. HOWARD UNIVERSITY HOSPITAL
WASHINGTON DC
20060
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-6100
  • Fax: 202-745-3731
Mailing address:
  • Phone: 202-865-6100
  • Fax: 202-745-3731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: