Provider Demographics
NPI:1588059752
Name:ILAIWY, GHASSAN (MD)
Entity type:Individual
Prefix:
First Name:GHASSAN
Middle Name:
Last Name:ILAIWY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GHASSAN
Other - Middle Name:
Other - Last Name:ILAIWY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2300 FALL HILL AVE STE 515
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3371
Mailing Address - Country:US
Mailing Address - Phone:540-741-0543
Mailing Address - Fax:540-741-0546
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-877-2835
Practice Address - Fax:202-877-8288
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101263994207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine