Provider Demographics
NPI:1194874172
Name:NWOKEUKU AUSTIN, CYNTHIA I (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:I
Last Name:NWOKEUKU AUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:I
Other - Last Name:NWOKEUKU AUSTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7009
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-7009
Mailing Address - Country:US
Mailing Address - Phone:571-492-7636
Mailing Address - Fax:540-683-8494
Practice Address - Street 1:3543 W BRADDOCK RD STE 400
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1900
Practice Address - Country:US
Practice Address - Phone:571-492-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054967207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F73975Medicare UPIN
014595K92Medicare ID - Type Unspecified