Provider Demographics
NPI:1689898066
Name:HALLAL, NADIM LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:NADIM
Middle Name:LOUIS
Last Name:HALLAL
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 1:7811 MONTROSE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3359
Mailing Address - Country:US
Mailing Address - Phone:301-588-7888
Mailing Address - Fax:
Practice Address - Street 1:7811 MONTROSE RD STE 340
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3359
Practice Address - Country:US
Practice Address - Phone:301-588-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD74147207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine