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General NPI Number Information
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NPI Number | 1588837249
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Entity Type | Organization
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Legal Business Name | EMERGENCY SURGERY, LLC
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 3133 BARKLEY DR
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City | FAIRFAX
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State | VA
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Zip | 22031-2720
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Country | US
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Telephone | 703-582-4482
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Fax |
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Provider Business Mailing Address
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Address Line | 3133 BARKLEY DR
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City | FAIRFAX
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State | VA
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Zip | 22031-2720
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ESAM SALEM OMEISH
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Credential |
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Telephone | 703-582-4482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 57717
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License Number State | VA
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