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Individual

ABDUL CONTEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16492 PLUMAGE EAGLE ST, WOODBRIDGE, VA 22191-6399
(703) 839-2467
Mailing address
16493 PLUMAGE EAGLE ST, WOODBRIDGE, VA 22191-6511

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002079205
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86-2589470
KLACS
VA
Enumeration date
03/12/2021
Last updated
03/12/2021
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