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Individual

GRISELDA MANI MEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
14009 MINNIEVILLE RD, WOODBRIDGE, VA 22193-2310
(703) 580-6400
(703) 580-6402
Mailing address
2200 OPITZ BLVD STE 355, WOODBRIDGE, VA 22191-3340
(703) 580-6400
(703) 580-4550

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101246974
VA
208000000X
Pediatrics Physician
Primary
N5869
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1407150113
VA
Enumeration date
01/10/2011
Last updated
11/04/2025
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