Provider Demographics
NPI:1861255341
Name:ADDAI, ADWOA
Entity type:Individual
Prefix:DR
First Name:ADWOA
Middle Name:
Last Name:ADDAI
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 1:8261 SHOPPERS SQ
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20111-2176
Mailing Address - Country:US
Mailing Address - Phone:703-479-7642
Mailing Address - Fax:888-570-2353
Practice Address - Street 1:8261 SHOPPERS SQ
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20111-2011
Practice Address - Country:US
Practice Address - Phone:703-479-7642
Practice Address - Fax:888-570-2353
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist