Individual
MR. GABRIEL O NWUFOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1690 OLD BRIDGE RD STE 200, WOODBRIDGE, VA 22192-8006
(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
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005821037
—
VA
01
—
281036
AMERIGROUP
VA
Enumeration date
07/29/2006
Last updated
05/03/2023
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