Provider Demographics
NPI:1154983724
Name:MOLLA, NOURAN WALEED (MBBS)
Entity type:Individual
Prefix:MS
First Name:NOURAN
Middle Name:WALEED
Last Name:MOLLA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3640 AL SA'ADAH STREET, ALYASMEEN DISTRICT
Mailing Address - Street 2:BUILDING NUMBER 13/A
Mailing Address - City:RIYADH
Mailing Address - State:RIYADH
Mailing Address - Zip Code:13325
Mailing Address - Country:SA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMTL0053242085B0100X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging