Provider Demographics
NPI:1063789196
Name:ABUYAMAN, NAWRAS M (RPH)
Entity type:Individual
Prefix:MRS
First Name:NAWRAS
Middle Name:M
Last Name:ABUYAMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10306 BRADING LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1589
Mailing Address - Country:US
Mailing Address - Phone:804-639-1725
Mailing Address - Fax:
Practice Address - Street 1:11119 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3203
Practice Address - Country:US
Practice Address - Phone:804-744-5986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist