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Individual

NADER A DAKAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12150 ANNAPOLIS RD, SUITE 105, GLENN DALE, MD 20769-9183
(301) 805-1250
(301) 805-0795
Mailing address
PO BOX 60443, POTOMAC, MD 20859-0443
(301) 805-1250
(301) 805-0795

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0046065
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022678700
DC MEDICAID NUMBER COPY ATTACHED TO FAX
DC
05
271000500
MD
01
490182
855I WAS ISSUED THREE YEARS AGO ON ADDRESS-REISSUING TODAY
DC
Enumeration date
11/07/2005
Last updated
06/24/2011
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