Healthcare Provider Details

I. General information

NPI: 1336439967
Provider Name (Legal Business Name): CHEIKHNA H. AIDARA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2011
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 12TH ST SE UNITY HEALTH CARE SUITE 120
WASHINGTON DC
20003-3722
US

IV. Provider business mailing address

8301 ASHFORD BLVD APT 117
LAUREL MD
20707-5644
US

V. Phone/Fax

Practice location:
  • Phone: 202-279-1817
  • Fax:
Mailing address:
  • Phone: 301-254-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA031281
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: