Healthcare Provider Details

I. General information

NPI: 1346710738
Provider Name (Legal Business Name): EMMA UEBELE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CONNECTICUT AVE NW STE 500
WASHINGTON DC
20036-5304
US

IV. Provider business mailing address

500 W ANNANDALE RD
FALLS CHURCH VA
22046-4205
US

V. Phone/Fax

Practice location:
  • Phone: 202-596-8891
  • Fax: 833-941-2357
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110007805
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: