Provider Demographics
NPI:1295704195
Name:AKROUT, JAMEL E (MD)
Entity type:Individual
Prefix:DR
First Name:JAMEL
Middle Name:E
Last Name:AKROUT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2921 TELESTAR CT
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1205
Mailing Address - Country:US
Mailing Address - Phone:703-280-1473
Mailing Address - Fax:703-280-2654
Practice Address - Street 1:2921 TELESTAR CT
Practice Address - Street 2:SUITE 140
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1205
Practice Address - Country:US
Practice Address - Phone:703-280-1473
Practice Address - Fax:703-280-2654
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101039268363AS0400X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7499124Medicaid
VA7499124Medicaid