Healthcare Provider Details

I. General information

NPI: 1063442754
Provider Name (Legal Business Name): MADINA HAQUE, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 N GEORGE MASON DR SUITE 410
ARLINGTON VA
22205-3601
US

IV. Provider business mailing address

1635 N GEORGE MASON DR SUITE 410
ARLINGTON VA
22205-3601
US

V. Phone/Fax

Practice location:
  • Phone: 703-525-2898
  • Fax: 703-525-4361
Mailing address:
  • Phone: 703-525-2898
  • Fax: 703-525-4361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DEWAN S HAQUE
Title or Position: VICE PRESIDENT
Credential:
Phone: 703-525-2898