Organization
MEDICAL CLINIC OF WOODBRIDGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIEL OBIORAH NWUFOH MD (PRESIDENT)
(703) 497-1964
Entity
Organization
Contact information
Practice address
12716 DIRECTORS LOOP, WOODBRIDGE, VA 22192
(703) 497-1964
(703) 497-9885
Mailing address
1690 OLD BRIDGE RD STE 200, WOODBRIDGE, VA 22192-8006
(703) 497-1964
(703) 497-9885
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101057783
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005821037
—
VA
Enumeration date
09/13/2007
Last updated
09/26/2024
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