Provider Demographics
NPI:1336583053
Name:PASKAL
Entity Type:Organization
Organization Name:PASKAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETROS
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-821-3040
Mailing Address - Street 1:17601 HARPERS FERRY DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-2029
Mailing Address - Country:US
Mailing Address - Phone:202-821-3040
Mailing Address - Fax:855-747-5544
Practice Address - Street 1:17601 HARPERS FERRY DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-2029
Practice Address - Country:US
Practice Address - Phone:202-821-3040
Practice Address - Fax:855-747-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101242641207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty