Provider Demographics
NPI:1821363219
Name:ALABASTER, OLIVER (MD)
Entity Type:Individual
Prefix:PROF
First Name:OLIVER
Middle Name:
Last Name:ALABASTER
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 1:4318 ADRIENNE DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2803
Mailing Address - Country:US
Mailing Address - Phone:703-780-2820
Mailing Address - Fax:
Practice Address - Street 1:4318 ADRIENNE DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2803
Practice Address - Country:US
Practice Address - Phone:703-780-2820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD11128207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD11128OtherDC MEDICAL LICENSE