Provider Demographics
NPI:1568576858
Name:MOAWAD, GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:
Last Name:MOAWAD
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 1:7507 CHRISLAND CV
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-7561
Mailing Address - Country:US
Mailing Address - Phone:703-776-2545
Mailing Address - Fax:703-776-2917
Practice Address - Street 1:7507 CHRISLAND CV
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-7561
Practice Address - Country:US
Practice Address - Phone:703-776-2545
Practice Address - Fax:703-776-2917
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240047207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC492203Medicare PIN