Individual
MARIA IFTIKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19415 DEERFIELD AVE SUITE 213, LEESBURG, VA 20176-8470
(703) 729-9220
(703) 858-3529
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(571) 291-9786
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053972190
—
VA
05
—
30016079970002
—
VA
Enumeration date
06/27/2019
Last updated
03/07/2024
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