Provider Demographics
NPI:1356056337
Name:TAWFIK, PETER
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:TAWFIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 18TH ST N APT 305
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-1595
Mailing Address - Country:US
Mailing Address - Phone:240-888-9092
Mailing Address - Fax:
Practice Address - Street 1:1615 18TH ST N APT 305
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-1595
Practice Address - Country:US
Practice Address - Phone:240-888-9092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH200004318183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist