Provider Demographics
NPI:1669924411
Name:ADAWI, BRANDON (HAD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:ADAWI
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19110 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:STE. 120
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3702
Mailing Address - Country:US
Mailing Address - Phone:301-977-6317
Mailing Address - Fax:301-977-8503
Practice Address - Street 1:1700 KINGFISHER DR
Practice Address - Street 2:STE. 27
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4775
Practice Address - Country:US
Practice Address - Phone:301-846-0222
Practice Address - Fax:301-846-7707
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02761237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist