Provider Demographics
NPI:1669781670
Name:AL-NAMAEH, MASHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:MASHAEL
Middle Name:
Last Name:AL-NAMAEH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S JOYCE ST APT 136
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-1805
Mailing Address - Country:US
Mailing Address - Phone:703-992-5424
Mailing Address - Fax:
Practice Address - Street 1:8230 MONTGOMERY RD STE 120
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2292
Practice Address - Country:US
Practice Address - Phone:877-506-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-26
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002015152W00000X
DCOP1000216152W00000X
MDDA 2221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist