Individual
DR. NIDAL MOHAMMAD QADDUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 23RD ST NW STE G-2092, WASHINGTON, DC 20037-2342
(202) 715-4750
(202) 715-4759
Mailing address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 715-4750
(202) 715-4759
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101266805
VA
207L00000X
Anesthesiology Physician
L0736
TX
207L00000X
Anesthesiology Physician
Primary
MD047552
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1115495
LOUISIANA MEDICAID
LA
05
—
143937405
—
TX
01
—
8S9660
BLUE CROSS PROVIDER ID
TX
01
—
P00260018
RAILROAD MEDICARE
TX
Enumeration date
10/12/2005
Last updated
11/08/2021
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