Provider Demographics
NPI:1649203118
Name:ELARINY, HAZEM A (MD, PHD, FACS)
Entity Type:Individual
Prefix:DR
First Name:HAZEM
Middle Name:A
Last Name:ELARINY
Suffix:
Gender:M
Credentials:MD, PHD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 CEDAR LN
Mailing Address - Street 2:302
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-5202
Mailing Address - Country:US
Mailing Address - Phone:703-778-6000
Mailing Address - Fax:703-778-6005
Practice Address - Street 1:2235 CEDAR LN
Practice Address - Street 2:302
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5202
Practice Address - Country:US
Practice Address - Phone:703-778-6000
Practice Address - Fax:703-778-6005
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057211208600000X
WI61708-202086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1649203118Medicaid
VA73-0921-0Medicaid
VA52400001OtherCARE FIRST
VA206776OtherANTHEM
VA342276OtherANTHEM BLUE CROSS-TCH
VA5850652OtherAETNA PPO
WV3810011401Medicaid
VA5076737003OtherCIGNA HMO
VA1649203118Medicaid
VA016516T57Medicare PIN
VA73-0921-0Medicaid