Provider Demographics
NPI:1932728870
Name:ALISLAMBOULI, MAWADDAH AHMED MOHAMED KHALIL (MD)
Entity Type:Individual
Prefix:
First Name:MAWADDAH
Middle Name:AHMED MOHAMED KHALIL
Last Name:ALISLAMBOULI
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Gender:F
Credentials:MD
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Mailing Address - Street 1:120 BRENTWOOD COMMONS WAY
Mailing Address - Street 2:STE 10
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2028
Mailing Address - Country:US
Mailing Address - Phone:615-371-5786
Mailing Address - Fax:253-240-0146
Practice Address - Street 1:351 VALLEY HEALTH WAY
Practice Address - Street 2:WARREN MEMORIAL HOSPITAL
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630
Practice Address - Country:US
Practice Address - Phone:615-371-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2024-01-17
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Provider Licenses
StateLicense IDTaxonomies
VA0101276760207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine