Healthcare Provider Details

I. General information

NPI: 1457106916
Provider Name (Legal Business Name): BATOOL AL-SHAAR M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 OLD COURTHOUSE RD STE 310
VIENNA VA
22182-3853
US

IV. Provider business mailing address

8230 OLD COURTHOUSE RD STE 310
VIENNA VA
22182-3853
US

V. Phone/Fax

Practice location:
  • Phone: 571-536-0163
  • Fax: 703-242-1454
Mailing address:
  • Phone: 571-536-0163
  • Fax: 703-242-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: