Individual
SAMANTHA L DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110
(703) 396-5292
(703) 396-5297
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(703) 396-5292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11855
NC
363A00000X
Physician Assistant
0110005843
VA
363AM0700X
Medical Physician Assistant
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—
Other
Enumeration date
06/21/2017
Last updated
08/13/2024
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