Individual
AMGAD W ABDOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3031 JAVIER RD., STE. 100, FAIRFAX, VA 22031
(703) 914-8000
(703) 560-8214
Mailing address
P.O. BOX 79088, BALTIMORE, MD 21279
(877) 632-9292
(480) 635-8111
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
35-087394
OH
208VP0014X
Interventional Pain Medicine Physician
Primary
35-087394
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513075
ANTHEM BC/BS
OH
05
—
2731842
—
OH
Enumeration date
03/15/2007
Last updated
05/25/2011
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