Provider Demographics
NPI:1275779456
Name:ALFAHAD, TARIQ BADER (BM, BCH)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:BADER
Last Name:ALFAHAD
Suffix:
Gender:M
Credentials:BM, BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW
Mailing Address - Street 2:7-404
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2700
Mailing Address - Fax:202-741-2721
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW
Practice Address - Street 2:7-404
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2700
Practice Address - Fax:202-741-2721
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program