Healthcare Provider Details

I. General information

NPI: 1831329093
Provider Name (Legal Business Name): ALIAA MAKKIYA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 DUKE ST
ALEXANDRIA VA
22314-4512
US

IV. Provider business mailing address

1351 N ROLFE ST APT B607
ARLINGTON VA
22209-3014
US

V. Phone/Fax

Practice location:
  • Phone: 571-293-1218
  • Fax:
Mailing address:
  • Phone: 989-293-2654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301091873
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number010128141
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: