Organization
ACCESSSTAR PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWASI ANWOMEA NP (ADMINISTRATOR)
(703) 468-1974
Entity
Organization
Contact information
Practice address
8705 STONEWALL RD, MANASSAS, VA 20110-4534
(703) 468-1974
Mailing address
8705 STONEWALL RD, MANASSAS, VA 20110-4534
(703) 468-1974
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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