Provider Demographics
NPI:1174936322
Name:AKWARI, QUEEN OYEDIYA
Entity type:Individual
Prefix:MRS
First Name:QUEEN
Middle Name:OYEDIYA
Last Name:AKWARI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:QUEEN
Other - Middle Name:OYEDIYA
Other - Last Name:BUYALOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1212 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-9400
Mailing Address - Country:US
Mailing Address - Phone:757-277-2774
Mailing Address - Fax:
Practice Address - Street 1:3531 AIRLINE BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-2642
Practice Address - Country:US
Practice Address - Phone:757-488-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist