Provider Demographics
NPI:1740207463
Name:TALIB, SAWSAN ATTIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAWSAN
Middle Name:ATTIA
Last Name:TALIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5791 WINSTON CT
Mailing Address - Street 2:SUITE# 160
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5822
Mailing Address - Country:US
Mailing Address - Phone:703-578-0500
Mailing Address - Fax:703-671-2357
Practice Address - Street 1:5791 WINSTON CT
Practice Address - Street 2:SUITE# 160
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-5822
Practice Address - Country:US
Practice Address - Phone:703-578-0500
Practice Address - Fax:703-671-2357
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010404782080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6700039Medicaid