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Individual

DR. JACK PETE AYOUB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19490 SANDRIDGE WAY, 350, LEESBURG, VA 20176
(703) 858-5599
(703) 858-5699
Mailing address
19490 SANDRIDGE WAY, 350, LEESBURG, VA 20176
(703) 858-5599
(703) 858-5699

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101244378
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1942440953
BUSINESS NPI
VA
Enumeration date
01/16/2007
Last updated
06/05/2015
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