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General NPI Number Information
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NPI Number | 1831805357
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Entity Type | Organization
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Legal Business Name | DVA MEDICAL LLC
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 8714 GEORGIA AVE
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City | SILVER SPRING
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State | MD
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Zip | 20910-3601
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Country | US
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Telephone | 301-276-4691
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Fax | 301-589-2007
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Provider Business Mailing Address
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Address Line | 400 ARMY NAVY DR APT 1127
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City | ARLINGTON
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State | VA
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Zip | 22202-4758
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Country | US
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Telephone | 848-391-9189
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DARE AJIBADE
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Credential | MD
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Telephone | 848-391-9189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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