Healthcare Provider Details

I. General information

NPI: 1851385926
Provider Name (Legal Business Name): EYAD ABU HAMDA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 PROSPERITY AVE STE 200
FAIRFAX VA
22031-4354
US

IV. Provider business mailing address

PO BOX 3178
MERRIFIELD VA
22116-3178
US

V. Phone/Fax

Practice location:
  • Phone: 703-208-2273
  • Fax: 703-208-1441
Mailing address:
  • Phone: 703-208-2273
  • Fax: 703-208-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101225495
License Number StateVA

VIII. Authorized Official

Name: DR. EYAD M ABU-HAMDA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 703-208-2273