MEDICARE: NADER A DAKAK 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	207RC0000X	Cardiovascular Disease Physician	D0046065	MD

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
3	490182	OTHER	DC	855I WAS ISSUED THREE YEARS AGO ON ADDRESS-REISSUING TODAY

General Provider Information

NPI Number	:	1457332652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADER A DAKAK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 60443
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20859-0443
Country	:	US
Telephone Number	:	301-805-1250
Fax Number	:	301-805-0795

Provider Business Practice Location Address
First Line	:	12150 ANNAPOLIS RD
Second Line	:	SUITE 105
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9183
Country	:	US
Telephone Number	:	301-805-1250
Fax Number	:	301-805-0795

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	06/24/2011

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Directions to “ NADER A DAKAK M.D.” Practice Location

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