Individual
OSAGIE UWADIA IGHILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9384 FORESTWOOD LN STE A, MANASSAS, VA 20110-4748
(703) 369-2999
(703) 369-3118
Mailing address
9384 FORESTWOOD LN STE A, MANASSAS, VA 20110-4748
(703) 369-2999
(703) 369-3118
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101282571
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105065
MEDICAID GROUP
OH
05
—
0409682
—
OH
01
—
341689161
TAX ID- JTDM FAMILY PRACTICE, LLC
OH
Enumeration date
03/27/2017
Last updated
04/13/2025
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