Provider Demographics
NPI:1376347674
Name:MASOUD, FADI DANIEL
Entity type:Individual
Prefix:
First Name:FADI
Middle Name:DANIEL
Last Name:MASOUD
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 1:3800 RESERVOIR RD NW DEPT OF INTERNAL MEDICINE
Mailing Address - Street 2:
Mailing Address - City:DC
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-741-1250
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW DEPT OF INTERNAL MEDICINE
Practice Address - Street 2:
Practice Address - City:DC
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-741-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program