Provider Demographics
NPI:1457954968
Name:TADROS, TAMER
Entity type:Individual
Prefix:
First Name:TAMER
Middle Name:
Last Name:TADROS
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 1:4427 DIXIE HILL RD APT 109
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-9082
Mailing Address - Country:US
Mailing Address - Phone:615-693-8605
Mailing Address - Fax:202-326-1407
Practice Address - Street 1:1117 10TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4311
Practice Address - Country:US
Practice Address - Phone:202-326-1401
Practice Address - Fax:202-326-1407
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH10003040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist