Basic Information
| Provider Information | |||||||||
| NPI: | 1184629420 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUAWWAD | ||||||||
| FirstName: | RAFIK | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3062 UNIVERSITY TER NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200163463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022480708 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 N 7TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172631220 | ||||||||
| FaxNumber: | 7172636255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2005 | ||||||||
| LastUpdateDate: | 12/23/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | D0029151 | MD | N | Other Service Providers | Specialist | 174400000X | MD13820 | DC | N | Other Service Providers | Specialist | 174400000X | 0101035253 | VA | N | Other Service Providers | Specialist | 174400000X | 14470 | NH | N | Other Service Providers | Specialist | 174400000X | C1-0008580 | DE | N | Other Service Providers | Specialist | 207X00000X | 126602 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD434872 | PA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 021721100 | 05 | DC | MEDICAID | 440551000 | 05 | MD | MEDICAID | 6438253 | 05 | VA | MEDICAID | 1184629420 | 05 | VA | MEDICAID | 102799836 | 05 | PA | MEDICAID | 03202215 | 05 | NY | MEDICAID |