Provider Demographics
NPI:1164056271
Name:MEDIWOUNDS INTERNATIONAL INC
Entity Type:Organization
Organization Name:MEDIWOUNDS INTERNATIONAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYSEER
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDAGHLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-855-1771
Mailing Address - Street 1:2776 S ARLINGTON MILL DR UNIT 505
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3402
Mailing Address - Country:US
Mailing Address - Phone:703-855-1771
Mailing Address - Fax:
Practice Address - Street 1:10701 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6904
Practice Address - Country:US
Practice Address - Phone:703-855-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty