Provider Demographics
NPI:1851741912
Name:ALKIMAWI MEDICAL INCORPORATED
Entity Type:Organization
Organization Name:ALKIMAWI MEDICAL INCORPORATED
Other - Org Name:MIRA INTEGRATIVE MEDICINE & GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKIMAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-732-9916
Mailing Address - Street 1:2557 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-5517
Mailing Address - Country:US
Mailing Address - Phone:703-732-9916
Mailing Address - Fax:
Practice Address - Street 1:2557 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-5517
Practice Address - Country:US
Practice Address - Phone:703-705-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty