# CHISOVEREIGN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225454291
- **Authorized official:** DR. IJEOMA N NNAMANI MD, PHD (DIRECTOR)
- **Authorized official phone:** (703) 505-2476

## Contact information

- **Practice address:** 3975 FAIR RIDGE DR, SUITE 150N, FAIRFAX, VA 22033-2911
- **Practice address phone:** (703) 246-0011
- **Practice address fax:** (703) 246-0012
- **Mailing address:** 3975 FAIR RIDGE DR, SUITE 150N, FAIRFAX, VA 22033-2911
- **Mailing address phone:** (703) 246-0011
- **Mailing address fax:** (703) 246-0012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 0101246435 | VA | Yes |

## Other

- **Enumeration date:** 03/13/2014
- **Last updated:** 03/13/2014