Provider Demographics
NPI:1386711869
Name:ABUL-HAWA, WALEED MAHMOUD (DC)
Entity type:Individual
Prefix:DR
First Name:WALEED
Middle Name:MAHMOUD
Last Name:ABUL-HAWA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 EISENHOWER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5301
Mailing Address - Country:US
Mailing Address - Phone:703-739-0500
Mailing Address - Fax:866-545-1147
Practice Address - Street 1:2034 EISENHOWER AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5301
Practice Address - Country:US
Practice Address - Phone:703-739-0500
Practice Address - Fax:866-545-1147
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001959111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF0650001OtherBCBS PROVIDER NUMBER
VA541901737OtherTAX ID
VA490329Medicare PIN