Healthcare Provider Details

I. General information

NPI: 1700973278
Provider Name (Legal Business Name): ROULA AMAL HAWIT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 SOLOMONS ISLAND RD STE E
HUNTINGTOWN MD
20639-8732
US

IV. Provider business mailing address

PO BOX 1229
DUNKIRK MD
20754-1229
US

V. Phone/Fax

Practice location:
  • Phone: 410-286-9844
  • Fax: 410-286-9843
Mailing address:
  • Phone: 410-286-9844
  • Fax: 410-286-9843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0058827
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: