Ili Wathen, PA-C

NPI #1063722577 in Waldorf, Maryland

Provider Information

NPI Number: 1063722577
Entity Type: Individual
Name: Ili Wathen, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 18, 2010
Last Updated: Jul 28, 2025

Practice Location

Address: 3500 OLD WASHINGTON RD STE 201
City: Waldorf
State: Maryland
ZIP Code: 20602-3238
Phone: (301) 396-2003

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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