Healthcare Provider Details

I. General information

NPI: 1467432146
Provider Name (Legal Business Name): NADIM A GELOO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 TELESTAR CT. #200
FALLS CHURCH VA
22042-1262
US

IV. Provider business mailing address

2901 TELESTAR CT. #300
FALLS CHURCH VA
22042-1263
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-3494
  • Fax: 703-573-5353
Mailing address:
  • Phone: 703-591-1688
  • Fax: 703-591-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101224504
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101224504
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: