Individual
MUKONG ADESO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UVA HOSPITAL, LEE STREET 1ST FLOOR, CHARLOTTESVILLE, VA 22908-0001
(434) 924-9954
(434) 982-6726
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101244064
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116015832
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619186004
—
VA
Enumeration date
05/22/2007
Last updated
02/10/2022
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