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General NPI Number Information
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NPI Number | 1457510463
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Entity Type | Individual
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Provider Name | ABDUL K HARES MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 2200 WILSON BLVD SUITE 102-251
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City | ARLINGTON
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State | VA
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Zip | 22201-3397
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Country | US
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Telephone | 248-228-0069
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 WILSON BOULEVARD SUITE 102-251
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City | ARLINGTON
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State | VA
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Zip | 22201
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Country | US
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Telephone | 248-228-0069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101249155
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License Number State | VA
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