Provider Demographics
NPI:1093957235
Name:JAROUDI, KAMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:
Last Name:JAROUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961A HUNTER MILL RD
Mailing Address - Street 2:# 276
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1704
Mailing Address - Country:US
Mailing Address - Phone:703-394-5324
Mailing Address - Fax:703-394-5285
Practice Address - Street 1:410 PINE ST SE
Practice Address - Street 2:SUITE 320
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4861
Practice Address - Country:US
Practice Address - Phone:703-938-1421
Practice Address - Fax:703-938-1424
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist