Individual
DR. GLORIA AYEYIDWOM ADDO AYENSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
10777 MAIN ST, #203, FAIRFAX, VA 22030
(703) 246-2479
(703) 273-0825
Mailing address
4025 SHAUGHNESSY CT, FAIRFAX, VA 22030
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0101059183
VA
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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