Provider Demographics
NPI:1063003994
Name:KHALIL-EKDAWI, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KHALIL-EKDAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23684 STRICKLAND DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7710
Mailing Address - Country:US
Mailing Address - Phone:571-367-6039
Mailing Address - Fax:
Practice Address - Street 1:23684 STRICKLAND DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7710
Practice Address - Country:US
Practice Address - Phone:571-367-6039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214755183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist