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Individual

DEGHA FONGOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
44121 HARRY BYRD HWY STE 145, ASHBURN, VA 20147-5667
(703) 879-4729
Mailing address
44121 HARRY BYRD HWY STE 145, ASHBURN, VA 20147-5667
(703) 879-4729

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101263117
VA

Other

Enumeration date
04/29/2013
Last updated
05/14/2020
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