Provider Demographics
NPI:1699859058
Name:KEBAISH, ADEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEL
Middle Name:S
Last Name:KEBAISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7787 LEESBURG PIKE
Mailing Address - Street 2:B
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2412
Mailing Address - Country:US
Mailing Address - Phone:703-506-4700
Mailing Address - Fax:703-734-1172
Practice Address - Street 1:7787 LEESBURG PIKE
Practice Address - Street 2:B
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2412
Practice Address - Country:US
Practice Address - Phone:703-506-4700
Practice Address - Fax:703-734-1172
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2014-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA040815207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6451209Medicaid
629323Medicare ID - Type Unspecified
VA6451209Medicaid