Individual
DWANA RASHAD SHABAZZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12011 LEE JACKSON MEMORIAL HWY STE 440, FAIRFAX, VA 22033-3335
(703) 865-6801
Mailing address
12011 LEE JACKSON MEMORIAL HWY SUITE 440, SUITE 303, FAIRFAX, VA 22033
(703) 865-6801
(703) 865-6784
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101240235
VA
207N00000X
Dermatology Physician
Primary
0101240235
VA
Other
Enumeration date
06/25/2006
Last updated
09/12/2017
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