NPI 1174300396 · live from the CMS NPI Registry
Omar Abdel Razzaq
Nurse Practitioner in Midlothian, VA. National Provider Identifier 1174300396, active.
NPI record
| NPI | 1174300396 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 14404 Sommerville Ct, Midlothian, VA 23113 |
| Practice phone | 804-378-1800 |
| Mailing address | 8803 Lawndell Rd, Henrico, VA 23229 |
| Enumerated | September 11, 2023 |
| Last updated | September 11, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | 0024187844 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.