Healthcare Provider Details

I. General information

NPI: 1609294065
Provider Name (Legal Business Name): PATRICIA MWESIGWA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 N GEORGE MASON DR STE 5C
ARLINGTON VA
22207-1953
US

IV. Provider business mailing address

1851 N GEORGE MASON DR STE 5C
ARLINGTON VA
22207-1953
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4163
  • Fax: 703-717-4165
Mailing address:
  • Phone: 703-717-4163
  • Fax: 703-717-4165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101279157
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number0101279157
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: