Healthcare Provider Details

I. General information

NPI: 1982081923
Provider Name (Legal Business Name): WALID EL-NAHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST FL 3
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

600 NORTH WOLFE STREET 1830 BLDG, ROOM 450B
BALTIMORE MD
21287-0005
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-1931
  • Fax: 434-295-6311
Mailing address:
  • Phone: 410-614-0919
  • Fax: 410-614-8588

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 StateMD
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101265943
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: