Healthcare Provider Details

I. General information

NPI: 1609732171
Provider Name (Legal Business Name): LINDA AYAWVI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10725 VENETIA MILL CIR APT 3B
SILVER SPRING MD
20901-1574
US

IV. Provider business mailing address

10725 VENETIA MILL CIR APT 3B
SILVER SPRING MD
20901-1574
US

V. Phone/Fax

Practice location:
  • Phone: 470-399-7287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0010261
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: