Healthcare Provider Details

I. General information

NPI: 1174755896
Provider Name (Legal Business Name): BATOUL ELAMIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2009
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 SUDLEY RD
MANASSAS VA
20110-4418
US

IV. Provider business mailing address

8700 SUDLEY RD
MANASSAS VA
20110-4418
US

V. Phone/Fax

Practice location:
  • Phone: 703-369-8134
  • Fax:
Mailing address:
  • Phone: 703-369-8134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27354
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number0101258886
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD040823
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: