Provider Demographics
NPI:1609021161
Name:AL-HOWAIDI, ISLAM ABDELRAHMAN (MD)
Entity Type:Individual
Prefix:
First Name:ISLAM
Middle Name:ABDELRAHMAN
Last Name:AL-HOWAIDI
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 1:2563 S CRATER RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2407
Mailing Address - Country:US
Mailing Address - Phone:804-520-1080
Mailing Address - Fax:804-520-1906
Practice Address - Street 1:2563 S CRATER RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2407
Practice Address - Country:US
Practice Address - Phone:804-520-1906
Practice Address - Fax:804-520-1906
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5827207R00000X
VA0101258674207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease