Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101260555 | VA |
N | 207Q00000X | Family Doctor | D0080145 | MD |
N | 207Q00000X | Family Doctor | MD453807 | PA |
NPI | 1003175589 |
---|---|
Provider Name | Dr. Jewel Bynoe Osborne-Wu |
First Address | Alexandria, VA 22306-6647 |
Second Address | Alexandria, VA 22306-6647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2012 |
Last Update Date | 08/08/2016 |