Provider Demographics
NPI:1578731808
Name:KHERBACHE, HEMET (MD)
Entity type:Individual
Prefix:DR
First Name:HEMET
Middle Name:
Last Name:KHERBACHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3289 WOODBURN RD STE 60
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-7337
Mailing Address - Country:US
Mailing Address - Phone:703-698-0666
Mailing Address - Fax:703-698-5935
Practice Address - Street 1:3289 WOODBURN RD STE 60
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7337
Practice Address - Country:US
Practice Address - Phone:703-698-0666
Practice Address - Fax:703-698-5935
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101281744207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH87035Medicare UPIN