Basic Information
| Provider Information | |||||||||
| NPI: | 1669924411 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAWI | ||||||||
| FirstName: | BRANDON | ||||||||
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| Credential: | H.A.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19110 MONTGOMERY VILLAGE AVE | ||||||||
| Address2: | STE. 120 | ||||||||
| City: | MONTGOMERY VILLAGE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208863702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019776317 | ||||||||
| FaxNumber: | 3019778503 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 KINGFISHER DR | ||||||||
| Address2: | STE. 27 | ||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217014775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018460222 | ||||||||
| FaxNumber: | 3018467707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2016 | ||||||||
| LastUpdateDate: | 11/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 02761 | MD | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.