Provider Demographics
NPI:1518906973
Name:HAQUE, ALMIRA A (PA-C)
Entity Type:Individual
Prefix:
First Name:ALMIRA
Middle Name:A
Last Name:HAQUE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALMIRA
Other - Middle Name:
Other - Last Name:CONTRACTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2900 TELESTAR CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1206
Mailing Address - Country:US
Mailing Address - Phone:703-538-2065
Mailing Address - Fax:703-852-7389
Practice Address - Street 1:24419 MILLSTREAM DR
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-5837
Practice Address - Country:US
Practice Address - Phone:703-957-1800
Practice Address - Fax:703-327-4004
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002955363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ42973Medicare UPIN