Individual
EVELYN C. MOGADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2901 TELESTAR CT STE 200, FALLS CHURCH, VA 22042-1262
(703) 573-3494
(703) 573-5353
Mailing address
4207 ANN FITZHUGH DR., ANNANDALE, VA 22003
(703) 796-3075
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001077801
VA
Other
Enumeration date
05/11/2006
Last updated
05/08/2023
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