Basic Information
| Provider Information | |||||||||
| NPI: | 1952499253 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | METWALLI | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10700 CHARTER DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210443629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107151864 | ||||||||
| FaxNumber: | 4105811603 | ||||||||
| Practice Location | |||||||||
| Address1: | 2041 GEORGIA AVE NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200603629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028657720 | ||||||||
| FaxNumber: | 2028651647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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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 | 208800000X | M2714 | TX | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | MD045414 | DC | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.