MEDICARE: DENISA IULIA MOREA MEEKMA MMS, PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	5601007512	MI

General Provider Information

NPI Number	:	1023477924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISA IULIA MOREA MEEKMA MMS, PA-C

Provider Business Mailing Address
First Line	:	100 LUNA PARK DR APT 429
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22305-3165
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7617 LITTLE RIVER TPKE STE 710
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-2635
Country	:	US
Telephone Number	:	703-941-0267
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	03/08/2022

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