Individual
MS. WASAMA IDLIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 HOSPITAL DR, WARRENTON, VA 20186-3027
(540) 316-5013
Mailing address
8228 FROG HOLLOW CT, MANASSAS, VA 20111-5259
(703) 582-3321
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005885
VA
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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