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General NPI Number Information
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NPI Number | 1710243902
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Entity Type | Individual
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Provider Name | WILLIAM FADEL RPH
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Gender | Male
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1800 MARTIN LUTHER KING JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020-6900
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Country | US
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Telephone | 202-503-3610
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Fax |
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Provider Business Mailing Address
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Address Line | 13901 ROCK BROOK CT
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City | CLIFTON
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State | VA
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Zip | 20124-2528
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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 |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202007294
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License Number State | VA
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