Individual
ABIMBOLA FASUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
220 L ST NE, WASHINGTON, DC 20002-3536
(202) 544-7580
Mailing address
2902 PORTER ST NW, WASHINGTON, DC 20008-3286
(202) 525-5287
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA030925
DC
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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