Healthcare Provider Details

I. General information

NPI: 1780618025
Provider Name (Legal Business Name): ALLYSON ANN ASKEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 WOODBURN RD SUITE 205
ANNANDALE VA
22003-1229
US

IV. Provider business mailing address

3301 WOODBURN RD SUITE 205
ANNANDALE VA
22003-1229
US

V. Phone/Fax

Practice location:
  • Phone: 703-560-2236
  • Fax: 703-876-4960
Mailing address:
  • Phone: 703-560-2236
  • Fax: 703-876-4960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101043562
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number036140301
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number25MA10358900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number57837
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: