Provider Demographics
NPI:1376784876
Name:DOUOGUIH, MACAYA JULIE (MD)
Entity Type:Individual
Prefix:
First Name:MACAYA
Middle Name:JULIE
Last Name:DOUOGUIH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 TRENTON HARBOURTON RD
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08560-1504
Mailing Address - Country:US
Mailing Address - Phone:609-737-2699
Mailing Address - Fax:
Practice Address - Street 1:11263 CENTER HARBOR RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-1320
Practice Address - Country:US
Practice Address - Phone:703-376-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine