Individual
MARIA WASIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21785 FILIGREE CT, SUITE 215, ASHBURN, VA 20147-6213
(571) 223-5610
Mailing address
42908 VESTALS GAP DR, BROADLANDS, VA 20148-4005
(571) 223-5610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101241267
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047720A
—
OK
01
—
731591743002
BCBS PIN
OK
Enumeration date
07/12/2006
Last updated
09/28/2011
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