Individual
DR. KHALID WASIMUDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14904 RICHMOND HWY STE 302, WOODBRIDGE, VA 22191-3908
(703) 499-9966
(703) 499-8515
Mailing address
15768 BEAU RIDGE DR, WOODBRIDGE, VA 22193-1028
(703) 499-9966
(703) 499-8515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101051384
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5800871
—
VA
05
—
5843758
—
VA
01
—
F83601
UPIN
VA
Enumeration date
10/03/2005
Last updated
09/23/2023
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