Provider Demographics
NPI:1720564131
Name:HITAWALA, ASIF ALI (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:ALI
Last Name:HITAWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CENTER DRIVE, BLDG. 10
Mailing Address - Street 2:ROOM 4-5722
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892
Mailing Address - Country:US
Mailing Address - Phone:301-402-1952
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DRIVE, BLDG. 10
Practice Address - Street 2:ROOM 4-5722
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892
Practice Address - Country:US
Practice Address - Phone:301-402-1952
Practice Address - Fax:301-451-9160
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.245594207R00000X
OH35.140242207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine