Provider Demographics
NPI:1386763373
Name:ABDULWAHABE, FOZIA T (MD)
Entity type:Individual
Prefix:DR
First Name:FOZIA
Middle Name:T
Last Name:ABDULWAHABE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 NICOL CIR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2907
Mailing Address - Country:US
Mailing Address - Phone:240-678-3750
Mailing Address - Fax:202-673-8010
Practice Address - Street 1:1901 D ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2534
Practice Address - Country:US
Practice Address - Phone:202-425-3814
Practice Address - Fax:202-673-8010
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD52500207R00000X
DCMD000030550207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH03004Medicare UPIN
DC021586M58Medicare PIN