Provider Demographics
NPI:1114795804
Name:QARAWI, MAHMOUD
Entity type:Individual
Prefix:DR
First Name:MAHMOUD
Middle Name:
Last Name:QARAWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 BECTON PL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5752
Mailing Address - Country:US
Mailing Address - Phone:703-896-8253
Mailing Address - Fax:
Practice Address - Street 1:328 LOUISA AVE STE 120
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4668
Practice Address - Country:US
Practice Address - Phone:757-428-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014192771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice