Provider Demographics
NPI:1750498598
Name:AWADELKARIM, FAISAL AWADALLA (MD)
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:AWADALLA
Last Name:AWADELKARIM
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 1:10102 EASTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2732
Mailing Address - Country:US
Mailing Address - Phone:571-274-7127
Mailing Address - Fax:703-383-9638
Practice Address - Street 1:10520 JUDICIAL DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5115
Practice Address - Country:US
Practice Address - Phone:703-246-4599
Practice Address - Fax:703-383-9638
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012314852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101231485OtherSTATE MEDICAL BARD LICENC