MEDICARE: ANDREA AYOROA MAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1790514420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA AYOROA MAC

Provider Business Mailing Address
First Line	:	8401 MAYLAND DR STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4648
Country	:	US
Telephone Number	:	301-941-7994
Fax Number	:	202-750-0094

Provider Business Practice Location Address
First Line	:	12321 MIDDLEBROOK RD STE 250
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-1591
Country	:	US
Telephone Number	:	301-941-7994
Fax Number	:	202-750-0094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	03/13/2026

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