Provider Demographics
NPI:1548659857
Name:NEJRABI, WEEDA (DMSC, MPAS, MS, PA-C)
Entity type:Individual
Prefix:
First Name:WEEDA
Middle Name:
Last Name:NEJRABI
Suffix:
Gender:F
Credentials:DMSC, MPAS, MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5741
Mailing Address - Fax:
Practice Address - Street 1:8503 ARLINGTON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4629
Practice Address - Country:US
Practice Address - Phone:571-423-5741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004795363A00000X
PAMA057310363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant