Individual
ANDRE GEORGES ENOWTAKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
4620 S LABURNUM AVE, RICHMOND, VA 23231-2424
(804) 226-2444
Mailing address
4620 S LABURNUM AVE, RICHMOND, VA 23231-2424
(804) 226-2444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101267632
VA
Other
Enumeration date
04/10/2017
Last updated
07/08/2020
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