Provider Demographics
NPI:1447223680
Name:AL-ATTAR, SHAWKI A (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWKI
Middle Name:A
Last Name:AL-ATTAR
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 1:10750 COLUMBIA PIKE STE 230
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4402
Mailing Address - Country:US
Mailing Address - Phone:301-585-9600
Mailing Address - Fax:301-585-5888
Practice Address - Street 1:10750 COLUMBIA PIKE STE 230
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:301-585-9600
Practice Address - Fax:301-585-5888
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0013874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD185471200Medicaid