Provider Demographics
NPI:1114220266
Name:MAURICE ATIYEH MD
Entity Type:Organization
Organization Name:MAURICE ATIYEH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATIYEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-828-7565
Mailing Address - Street 1:PO BOX 61306
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23466-1306
Mailing Address - Country:US
Mailing Address - Phone:703-828-7565
Mailing Address - Fax:866-696-6573
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:STE 500
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4617
Practice Address - Country:US
Practice Address - Phone:703-828-7565
Practice Address - Fax:866-696-6573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040124207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty