Healthcare Provider Details

I. General information

NPI: 1447537683
Provider Name (Legal Business Name): SABAA DAM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 WILSON BLVD
ARLINGTON VA
22203-1953
US

IV. Provider business mailing address

3902 WILSON BLVD
ARLINGTON VA
22203-1953
US

V. Phone/Fax

Practice location:
  • Phone: 571-560-2648
  • Fax: 571-560-2649
Mailing address:
  • Phone: 571-560-2648
  • Fax: 571-560-2649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4818
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110011472
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: