Healthcare Provider Details

I. General information

NPI: 1235724063
Provider Name (Legal Business Name): SAMA ALAZAWI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4494 PALMER RD N, MD 20814
BETHESDA MD
20814
US

IV. Provider business mailing address

4494 PALMER RD N, MD 20814
BETHESDA MD
20814
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4000
  • Fax:
Mailing address:
  • Phone: 301-295-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: