Basic Information
| Provider Information | |||||||||
| NPI: | 1861693350 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL ALWANI | ||||||||
| FirstName: | MAZEN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 J CLYDE MORRIS BLVD | ||||||||
| Address2: | RRMC DEPARTMENT OF MEDICAL EDUCATION OBGYN | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236011929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575944737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10510 JEFFERSON AVE | ||||||||
| Address2: | STE. D BRENTWOOD OBGYN | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236013102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575944737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207V00000X | 0116018115 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.