NPI 1134216674
Gloria Ayeyidwom Addo Ayensu, MDMPH
Practice location
- Address
- 10777 Main St #203, Fairfax, VA 22030
- Phone
- (703) 246-2479
- Fax
- (703) 273-0825
- Mailing address
- 4025 Shaughnessy CT, Fairfax, VA 22030
Registered specialties
Public Health & General Preventive Medicine Physician
Primary
Registry record
- NPI
- 1134216674
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 6 Oct 2006
- Record last updated
- 8 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.