Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 29470 | NE |
NPI | 1245625094 |
---|---|
Provider Name | Ayeetin Azah |
First Address | Nashville, TN 37228-1328 |
Second Address | Bethesda, MD 20889-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 27/06/2017 |