Provider Demographics
NPI:1932104023
Name:HONAINY, HASSAN K (MD)
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:K
Last Name:HONAINY
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 1:6020 RICHMOND HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2157
Mailing Address - Country:US
Mailing Address - Phone:443-393-3653
Mailing Address - Fax:
Practice Address - Street 1:200 ARH LANE, STE 400
Practice Address - Street 2:JACKSON RIVER NEPHROLOGY
Practice Address - City:LOW MOOR
Practice Address - State:VA
Practice Address - Zip Code:24457
Practice Address - Country:US
Practice Address - Phone:540-862-7064
Practice Address - Fax:540-862-5727
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18529207RN0300X
VA0101052321207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5807477OtherAETNA
VA005869404Medicaid
VA282210OtherANTHEM
VA006099475Medicaid
VA541839718030OtherBS MOUNTAIN STATE
WV0078034000Medicaid
WV54183971800OtherWV WORKERS COMPENSATION
WV541839718053OtherBS MOUNTAIN STATE
VA541839718030OtherBS MOUNTAIN STATE
5807477OtherAETNA
F32496Medicare UPIN
WV0078034000Medicaid
WV0677562Medicare PIN
VA005869404Medicaid
1200890010OtherADMINSTAR FEDERAL
WV541839718053OtherBS MOUNTAIN STATE
WV54183971800OtherWV WORKERS COMPENSATION
541839718OtherC&O
58106OtherSOUTHERN HEALTH
WV0078034000Medicaid