Provider Demographics
NPI:1114614898
Name:JAFAR, OMAR (MD)
Entity Type:Individual
Prefix:MR
First Name:OMAR
Middle Name:
Last Name:JAFAR
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 1:735 FAIRFAX AVENUE
Mailing Address - Street 2:SUITE 1017C
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507
Mailing Address - Country:US
Mailing Address - Phone:757-446-6177
Mailing Address - Fax:
Practice Address - Street 1:735 FAIRFAX AVENUE
Practice Address - Street 2:SUITE 1017C
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507
Practice Address - Country:US
Practice Address - Phone:757-446-8920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program