Provider Demographics
NPI:1639185374
Name:MIHELICH, CATHLEEN MARGUERITE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CATHLEEN
Middle Name:MARGUERITE
Last Name:MIHELICH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8939 ROYAL ASTOR WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1499
Mailing Address - Country:US
Mailing Address - Phone:703-585-9006
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:703-580-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002331363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical