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General NPI Number Information
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NPI Number | 1811800907
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Entity Type | Organization
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Legal Business Name | NOVA INNOVATIVE GASTROENTEROLOGY, PLCC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 24430 STONE SPRINGS BLVD STE 250
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City | STERLING
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State | VA
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Zip | 20166-2268
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Country | US
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Telephone | 206-832-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 24430 STONE SPRINGS BLVD STE 250
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City | STERLING
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State | VA
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Zip | 20166-2268
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Country | US
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Telephone | 206-832-7770
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | TOKUNBO AJAYI
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Credential | MD
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Telephone | 206-832-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | NULL
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