Healthcare Provider Details

I. General information

NPI: 1801532767
Provider Name (Legal Business Name): MRS. MARIA NAWAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 GODWIN BLVD STE 360
SUFFOLK VA
23434-8153
US

IV. Provider business mailing address

THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION 501 S. WASHINGTON AVE., SUITE 1000
SCRANTON PA
18505
US

V. Phone/Fax

Practice location:
  • Phone: 757-261-8070
  • Fax:
Mailing address:
  • Phone: 570-866-3058
  • Fax: 570-343-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101284986
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: