Provider Demographics
NPI:1982766614
Name:OMEISH, ESAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:ESAM
Middle Name:S
Last Name:OMEISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 8325
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-8325
Mailing Address - Country:US
Mailing Address - Phone:703-360-9700
Mailing Address - Fax:703-780-9229
Practice Address - Street 1:2849 DUKE ST STE 14
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4512
Practice Address - Country:US
Practice Address - Phone:703-360-9700
Practice Address - Fax:703-780-9229
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2024-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101057717208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007309503Medicaid
VA007309503Medicaid