Individual
AHGNES UNGOCO BOLUSA-SABUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 FEDERAL ST, LYNCHBURG, VA 24504-2306
(434) 947-5967
(434) 455-2487
Mailing address
134 ELON RD, MADISON HEIGHTS, VA 24572-2536
(434) 455-2480
(434) 455-2487
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101243921
VA
207Q00000X
Family Medicine Physician
266535
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03495012
—
NY
Enumeration date
04/24/2008
Last updated
05/13/2024
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