Individual
DR. MINA M YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1328 SOUTHERN AVE SE, STE 312, WASHINGTON, DC 20020
(202) 563-2844
(202) 563-2337
Mailing address
1328 SOUTHERN AVE SE, STE 312, WASHINGTON, DC 20020
(202) 563-2844
(202) 563-2337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101232738
VA
207R00000X
Internal Medicine Physician
Primary
MD33941
DC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D0063530
MD
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD33941
DC
207RP1001X
Pulmonary Disease Physician
D0063530
MD
207RP1001X
Pulmonary Disease Physician
MD33941
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6875-0048
CAREFIRST BLUE CROSS
—
01
—
P00381288
UHC RAILROAD
—
Enumeration date
06/27/2005
Last updated
11/29/2007
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