MEDICARE: DR. MOWAFFAK ALHAMAD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD9379	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447236633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOWAFFAK ALHAMAD M.D.

Provider Business Mailing Address
First Line	:	1140 VARNUM ST NE
Second Line	:	SUITE 202
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2151
Country	:	US
Telephone Number	:	202-635-3365
Fax Number	:	202-269-6484

Provider Business Practice Location Address
First Line	:	1140 VARNUM ST NE
Second Line	:	SUITE 202
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2151
Country	:	US
Telephone Number	:	202-635-3365
Fax Number	:	202-269-6484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	11/13/2009

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