Healthcare Provider Details

I. General information

NPI: 1467160655
Provider Name (Legal Business Name): JIHAD ALWARITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24430 STONE SPRINGS BLVD STE 400
DULLES VA
20166-2268
US

IV. Provider business mailing address

24430 STONE SPRINGS BLVD STE 400
DULLES VA
20166-2268
US

V. Phone/Fax

Practice location:
  • Phone: 703-766-5040
  • Fax: 703-766-5047
Mailing address:
  • Phone: 703-766-5040
  • Fax: 703-766-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: