Provider Demographics
NPI:1558654368
Name:OWUSU-NYAMEKYE, NANA ADOMA (MD)
Entity Type:Individual
Prefix:
First Name:NANA ADOMA
Middle Name:
Last Name:OWUSU-NYAMEKYE
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 1:4500 POND WAY
Mailing Address - Street 2:STE 170
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5581
Mailing Address - Country:US
Mailing Address - Phone:571-542-4950
Mailing Address - Fax:
Practice Address - Street 1:4500 POND WAY
Practice Address - Street 2:STE 170
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5581
Practice Address - Country:US
Practice Address - Phone:571-542-4950
Practice Address - Fax:571-285-1160
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine