Provider Demographics
NPI:1790028850
Name:JABER, OMAR (MD, MPH)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:JABER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PENNSYLVANIA AVE SE STE C100
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4368
Mailing Address - Country:US
Mailing Address - Phone:202-833-4543
Mailing Address - Fax:
Practice Address - Street 1:650 PENNSYLVANIA AVE SE STE C100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4368
Practice Address - Country:US
Practice Address - Phone:202-833-4543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6419208000000X
VA0101260177208000000X
390200000X
DCMD047440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program