Provider Demographics
NPI:1689764532
Name:OSMAN, GIATH ALSHKAKI (MD,FACS,FRCSI)
Entity Type:Individual
Prefix:DR
First Name:GIATH
Middle Name:ALSHKAKI
Last Name:OSMAN
Suffix:
Gender:M
Credentials:MD,FACS,FRCSI
Other - Prefix:
Other - First Name:GIATH
Other - Middle Name:
Other - Last Name:ALSHKAKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,FACS,FRCSI
Mailing Address - Street 1:770 POTOMAC RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-1429
Mailing Address - Country:US
Mailing Address - Phone:703-409-2882
Mailing Address - Fax:
Practice Address - Street 1:4660 KENMORE AVE STE 220
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1306
Practice Address - Country:US
Practice Address - Phone:703-888-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0026285208600000X
DCMD036848208600000X
NMMD2015-0216208600000X, 207RG0100X
VA0101239512208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC134689Medicare PIN