Basic Information
Provider Information
NPI: 1659639516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALKHATIB
FirstName: MARAM
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MB, BCH, BAO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2150 PENNSYLVANIA AVE NW
Address2: THE GW MEDICAL FACULTY ASSOCIATES
City: WASHINGTON
State: DC
PostalCode: 200373201
CountryCode: US
TelephoneNumber: 2027413000
FaxNumber:  
Practice Location
Address1: 2150 PENNSYLVANIA AVE NW
Address2: THE GW MEDICAL FACULTY ASSOCIATES
City: WASHINGTON
State: DC
PostalCode: 200373201
CountryCode: US
TelephoneNumber: 2027413000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/30/2012
LastUpdateDate: 11/24/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD043553DCY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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