Individual
FELLA EZZEKMI-AKSOUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
201 ELDEN ST, STE #101, HERNDON, VA 20170-4853
(703) 668-0222
(703) 668-0224
Mailing address
201 ELDEN ST, STE #101, HERNDON, VA 20170-4853
(703) 668-0222
(703) 668-0224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001167
VA
363AM0700X
Medical Physician Assistant
0110001667
VA
Other
Enumeration date
01/11/2011
Last updated
11/27/2023
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