Basic Information
Provider Information
NPI: 1700885902
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FAHMI
FirstName: MUNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7068
Address2:  
City: PORTSMOUTH
State: VA
PostalCode: 237070068
CountryCode: US
TelephoneNumber: 7579678622
FaxNumber: 7576860541
Practice Location
Address1: 736 BATTLEFIELD BLVD N
Address2:  
City: CHESAPEAKE
State: VA
PostalCode: 233204941
CountryCode: US
TelephoneNumber: 7579678622
FaxNumber: 7576860541
Other Information
ProviderEnumerationDate: 07/19/2005
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101237706VAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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