Individual
MR. JALAL ALGHABRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1985 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-6233
(540) 373-6647
Mailing address
1985 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22401-6233
(540) 373-6647
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-05866
NC
363A00000X
Physician Assistant
Primary
0110005989
VA
363AM0700X
Medical Physician Assistant
0010-05886
NC
363AM0700X
Medical Physician Assistant
5601004169
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-05866
NC MEDICAL BOARD
NC
01
—
0110005989
VA MEDICAL BOARD
VA
Enumeration date
05/27/2015
Last updated
01/03/2019
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