Healthcare Provider Details

I. General information

NPI: 1982157608
Provider Name (Legal Business Name): RALPH MAROUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2016
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY
RESTON VA
20190-3204
US

IV. Provider business mailing address

PO BOX 207830
DALLAS TX
75320-7830
US

V. Phone/Fax

Practice location:
  • Phone: 703-689-9000
  • Fax:
Mailing address:
  • Phone: 888-412-2649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101287781
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number64455
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: