1326083940 NPI number — EVELINE BIYOGA ANE MD

Table of content: EVELINE BIYOGA ANE MD (NPI 1326083940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326083940 NPI number — EVELINE BIYOGA ANE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANE
Provider First Name:
EVELINE
Provider Middle Name:
BIYOGA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326083940
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8116 GOOD LUCK RD
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
LANHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20706-3502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-552-1200
Provider Business Mailing Address Fax Number:
301-552-1202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7219 HANOVER PKWY
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
GREENBELT
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20770-2021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-486-7580
Provider Business Practice Location Address Fax Number:
301-486-7581
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D0064690 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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