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General NPI Number Information
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NPI Number | 1801021134
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Entity Type | Individual
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Provider Name | KARIM RAAFAT SELIM YACOUB MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 1701 N GEORGE MASON DR
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City | ARLINGTON
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State | VA
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Zip | 22205-3610
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Country | US
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Telephone | 571-512-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 10703 SIMPSON MEWS LN
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City | FAIRFAX
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State | VA
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Zip | 22030-8136
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Country | US
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Telephone | 703-223-9747
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101252046
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License Number State | VA
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