Ibrahim E.M. Elfadil Jr., SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

13305 Huntington LN
Woodbridge, VA 22193

Phone

(571) 572-8176

NPI assigned

Aug 9, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ibrahim E.M. Elfadil Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1528214533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 HUNTINGTON LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935130",
            "telephone_number": "571-572-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 HUNTINGTON LN",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "571-572-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELFADIL",
        "first_name": "IBRAHIM",
        "middle_name": "E.M.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-09",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IBRAHIM",
            "last_name": "ELFADIL",
            "middle_name": "E.M.",
            "credential": "SA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Surgical Assistant in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Surgical Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.