Provider Demographics
NPI:1356310551
Name:ANDRAWIS, NABIL S (MD)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:S
Last Name:ANDRAWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5631 BURKE CENTRE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2234
Mailing Address - Country:US
Mailing Address - Phone:703-250-5171
Mailing Address - Fax:703-250-5170
Practice Address - Street 1:5631 BURKE CENTRE PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2234
Practice Address - Country:US
Practice Address - Phone:703-250-5171
Practice Address - Fax:703-250-5170
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5802547Medicaid
VA5802547Medicaid