Provider Demographics
NPI:1750524898
Name:ASOMUGHA, EVA UMOH (MD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:UMOH
Last Name:ASOMUGHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:MACAULAY
Other - Last Name:UMOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 75868
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-5868
Mailing Address - Country:US
Mailing Address - Phone:703-383-6469
Mailing Address - Fax:703-810-5369
Practice Address - Street 1:6355 WALKER LANE
Practice Address - Street 2:STE 202
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3257
Practice Address - Country:US
Practice Address - Phone:703-810-5210
Practice Address - Fax:703-810-5418
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101260371207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program