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General NPI Number Information
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NPI Number | 1538358312
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Entity Type | Organization
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Legal Business Name | ABDUL H. FADUL MD LLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 6228 OXON HILL RD
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City | OXON HILL
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State | MD
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Zip | 20745-3033
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Country | US
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Telephone | 301-870-3540
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Fax | 301-392-1726
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Provider Business Mailing Address
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Address Line | PO BOX 1098
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City | OXON HILL
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State | MD
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Zip | 20750-1098
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Country | US
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Telephone | 301-870-3540
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Fax | 301-392-1726
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Authorized Official
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Title or Position | ADMINISTATOR
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Name | MARYANN AYERS
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Credential |
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Telephone | 301-870-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D0015765
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License Number State | MD
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