Provider Demographics
NPI:1952047490
Name:FOZIA T ABDULWAHABE MDPA
Entity Type:Organization
Organization Name:FOZIA T ABDULWAHABE MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FOZIA
Authorized Official - Middle Name:TOFIK
Authorized Official - Last Name:ABDULWAHABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-678-3750
Mailing Address - Street 1:25300 TALENT ST
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6649
Mailing Address - Country:US
Mailing Address - Phone:240-678-3750
Mailing Address - Fax:
Practice Address - Street 1:4922 LASALLE RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3302
Practice Address - Country:US
Practice Address - Phone:301-864-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty