Individual
ATIYA MOMIN ATIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13861 HULL STREET RD, MIDLOTHIAN, VA 23112-2091
(804) 739-0910
(804) 739-2763
Mailing address
13861 HULL STREET ROAD, MIDLOTHIAN, VA 23112
(804) 739-0910
(804) 739-2763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101241836
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578592366
—
VA
Enumeration date
07/02/2006
Last updated
12/10/2010
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