Individual
JENNIFER T WARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8629 SUDLEY RD, SUITE 102, MANASSAS, VA 20110-4590
(703) 361-3030
Mailing address
8629 SUDLEY RD, SUITE 102, MANASSAS, VA 20110-4590
(703) 361-3030
(703) 361-2687
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101230648
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6688-0021
CAREFIRST
VA
05
—
7237456
—
VA
05
—
7237464
—
VA
05
—
7237511
—
VA
05
—
7237529
—
VA
05
—
7247575
—
VA
Enumeration date
04/18/2006
Last updated
11/04/2011
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