Healthcare Provider Details

I. General information

NPI: 1023257581
Provider Name (Legal Business Name): NASAAZI MUGISHA LWANGA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 W DIAMOND AVE STE 120
GAITHERSBURG MD
20878-1450
US

IV. Provider business mailing address

6701 DEMOCRACY BLVD STE 300
BETHESDA MD
20817-7500
US

V. Phone/Fax

Practice location:
  • Phone: 301-963-6334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: