Healthcare Provider Details

I. General information

NPI: 1528419496
Provider Name (Legal Business Name): WAQAS MEMON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GEORGE MASON DR
ARLINGTON VA
22205-3610
US

IV. Provider business mailing address

1701 N GEORGE MASON DR
ARLINGTON VA
22205-3610
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125068143
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101266586
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0101266586
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: