Individual
ABDIRISAK WASUGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10805 MAIN ST, STE 700, FAIRFAX, VA 22030-4729
(571) 230-5342
Mailing address
10805 MAIN ST, STE 700, FAIRFAX, VA 22030-4729
(571) 230-5342
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HCO-151169
VA
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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