Provider Information for 1548296817
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DWANA RASHAD SHABAZZ M.D.
Other Names:Former Name:DWANA RASHAD LYNCHSex: Female
NPI: 1548296817
Last Updated: 2017-09-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1548296817 | ||||||||||||
| Enumeration Date | 2006-06-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 12011 LEE JACKSON MEMORIAL HWY SUITE 440 SUITE 303 FAIRFAX, VA 22033 United States Phone: 703-865-6801 | Fax:703-865-6784 | ||||||||||||
| Primary Practice Address | 12011 LEE JACKSON MEMORIAL HWY STE 440 FAIRFAX, VA 22033-3335 United States Phone: 703-865-6801 | Fax: | ||||||||||||
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