Individual
EDWARD A LONGWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2041 GEORGIA AVE NW, SUITE 2-B, WASHINGTON, DC 20060-0001
(202) 865-1491
Mailing address
24805 PINEBROOK RD, SUITE 100, CHANTILLY, VA 20152-4126
(703) 327-0955
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN1000625
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087875822
DRIVER LICENSE
TN
Enumeration date
05/04/2007
Last updated
08/29/2012
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