Individual
MEENA S. EGO-OSUALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
10521 ROSEHAVEN ST STE LL100, FAIRFAX, VA 22030-2877
(703) 281-5000
(703) 255-0765
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339
(301) 340-9027
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05017
NC
363A00000X
Physician Assistant
0110006185
VA
363A00000X
Physician Assistant
C0003570
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972796399
—
NC
05
—
2586PA
—
SC
Enumeration date
08/20/2007
Last updated
05/13/2021
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