Fella Ezzekmi-Aksouh, PAC

NPI #1912202664 in Herndon, Virginia

Provider Information

NPI Number: 1912202664
Entity Type: Individual
Name: Fella Ezzekmi-Aksouh, PAC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Jan 11, 2011
Last Updated: Nov 27, 2023

Practice Location

Address: 201 ELDEN ST
Address 2: STE #101
City: Herndon
State: Virginia
ZIP Code: 20170-4853
Phone: (703) 668-0222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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