MEDICARE: NADIM LOUIS HALLAL 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	D74147	MD
2	207X00000X	Orthopaedic Surgery Physician	D74147	MD

General Provider Information

NPI Number	:	1689898066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIM LOUIS HALLAL M.D.

Provider Business Mailing Address
First Line	:	7811 MONTROSE RD STE 340
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-3359
Country	:	US
Telephone Number	:	301-588-7888
Fax Number	:

Provider Business Practice Location Address
First Line	:	7811 MONTROSE RD STE 340
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-3359
Country	:	US
Telephone Number	:	301-588-7888
Fax Number	:

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	06/14/2023

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