Provider Demographics
NPI:1558939843
Name:BAKAIN, TAREK WALEED (MBBS)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:WALEED
Last Name:BAKAIN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING STREET NW
Mailing Address - Street 2:STE 2A50
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010
Mailing Address - Country:US
Mailing Address - Phone:202-877-8271
Mailing Address - Fax:202-877-8288
Practice Address - Street 1:110 IRVING STREET NW
Practice Address - Street 2:STE 2A50
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-8271
Practice Address - Fax:202-877-8288
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2023-05-18
Deactivation Date:2023-04-03
Deactivation Code:
Reactivation Date:2023-05-18
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMTL400001270390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program