Healthcare Provider Details

I. General information

NPI: 1528794013
Provider Name (Legal Business Name): BILAL LOUZATI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 GODWIN BLVD STE 355
SUFFOLK VA
23434-8173
US

IV. Provider business mailing address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 757-983-8520
  • Fax:
Mailing address:
  • Phone: 202-444-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO50083029
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: