Healthcare Provider Details

I. General information

NPI: 1457928574
Provider Name (Legal Business Name): ASSAAD M SOWEID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. ASSAAD MOHAMMAD SOWEID

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARTHA JEFFERSON DR
CHARLOTTESVILLE VA
22911-4668
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 434-654-5260
  • Fax:
Mailing address:
  • Phone: 571-423-5699
  • Fax: 571-423-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME150612
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD91692
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0101275184
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: