Individual
EASA AL-GHANDOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101260981
VA
207R00000X
Internal Medicine Physician
LP01636
RI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
0101260981
VA
207RP1001X
Pulmonary Disease Physician
0101260981
VA
Other
Enumeration date
07/09/2009
Last updated
06/06/2023
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