Healthcare Provider Details

I. General information

NPI: 1720196306
Provider Name (Legal Business Name): SAAD AL-HARIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 LEESBURG PIKE SUITE 400
FALLS CHURCH VA
22041-2314
US

IV. Provider business mailing address

5881 LEESBURG PIKE SUITE 400
FALLS CHURCH VA
22041-2314
US

V. Phone/Fax

Practice location:
  • Phone: 703-820-2899
  • Fax:
Mailing address:
  • Phone: 703-820-2899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101051396
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: