Individual
DR. HIND BOUALLALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
20745 WILLIAMSPORT PL STE 340, ASHBURN, VA 20147-6520
(917) 664-1143
Mailing address
1135 SECRETARIAT CT, GREAT FALLS, VA 22066-1715
(917) 664-1143
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101265045
VA
208000000X
Pediatrics Physician
262731
NY
261QP2300X
Primary Care Clinic/Center
262731
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03127837
—
NY
Enumeration date
05/14/2008
Last updated
07/21/2022
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