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Search › Virginia › 225100000X

Mariah Idul

NPI 1780314682 · on the registry since 2022 · sole proprietor

Practice

Address
501 Discovery Dr
Chesapeake, VA 23320
Phone
(757) 547-5145
Organisation at this address
Sports Medicine And Orthopaedic Center
Sport Medicine And Orthopaedic Center Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
25

Registry record

Primary taxonomy
225100000X
225100000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-06-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia