Provider Demographics
NPI:1730443995
Name:LEKANE, GLWADYS MEJIEU
Entity type:Individual
Prefix:DR
First Name:GLWADYS
Middle Name:MEJIEU
Last Name:LEKANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-6410
Mailing Address - Country:US
Mailing Address - Phone:703-253-9908
Mailing Address - Fax:703-253-9902
Practice Address - Street 1:6303 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-6410
Practice Address - Country:US
Practice Address - Phone:703-253-9908
Practice Address - Fax:703-253-9902
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD238161835P2201X
374U00000X
VA02022144421835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No374U00000XNursing Service Related ProvidersHome Health Aide