MEDICARE: DR. ABDUL K HARES MD

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	207Q00000X	Family Medicine Physician	0101249155	VA

General Provider Information

NPI Number	:	1457510463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDUL K HARES MD

Provider Business Mailing Address
First Line	:	2200 WILSON BOULEVARD
Second Line	:	SUITE 102-251
City	:	ARLINGTON
State	:	VA
Zip	:	22201
Country	:	US
Telephone Number	:	248-228-0069
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 WILSON BLVD
Second Line	:	SUITE 102-251
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3397
Country	:	US
Telephone Number	:	248-228-0069
Fax Number	:

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

Provider Enumeration Date	:	06/04/2008
Last Update Date	:	04/05/2011

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