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General NPI Number Information
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NPI Number | 1578459715
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Entity Type | Individual
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Provider Name | DR. FIONA OBIAMAKA EMEMBOLU
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 96 15TH ST NW STE 104
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City | NORTON
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State | VA
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Zip | 24273-1600
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Country | US
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Telephone | 276-679-0321
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Fax | 276-439-1872
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Provider Business Mailing Address
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Address Line | 884 GRANBY RD
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City | KINGSPORT
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State | TN
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Zip | 37660-6929
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0116040324
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License Number State | VA
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