Organization
CHISOVEREIGN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IJEOMA N NNAMANI MD, PHD (DIRECTOR)
(703) 505-2476
Entity
Organization
Contact information
Practice address
3975 FAIR RIDGE DR, SUITE 150N, FAIRFAX, VA 22033-2911
(703) 246-0011
(703) 246-0012
Mailing address
3975 FAIR RIDGE DR, SUITE 150N, FAIRFAX, VA 22033-2911
(703) 246-0011
(703) 246-0012
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0101246435
VA
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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