Provider Demographics
NPI:1043299472
Name:TAWIL, GEORGE W (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:TAWIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10301 DEMOCRACY LANE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-876-5942
Mailing Address - Fax:703-876-5972
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 735
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-370-2132
Practice Address - Fax:703-370-8117
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA33631208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B50711Medicare UPIN
VA019392N82Medicare PIN
P00307683Medicare PIN
B50711Medicare PIN
053313Medicare ID - Type Unspecified