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NPI Code Detail

MEDICARE: OGECHUKWU IMONUGO DPM

MEDICARE: OGECHUKWU IMONUGO DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist01682MD

General Provider Information

NPI Number : 1619330172
Entity Type Code : Individual
Provider Name (Legal Business Name) : OGECHUKWU IMONUGO DPM
Provider Business Mailing Address
First Line : 1 N MAIN ST
Second Line :
City : BEL AIR
State : MD
Zip : 21014-3592
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5500 KNOLL NORTH DR STE 440
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2364
Country : US
Telephone Number : 410-730-0970
Fax Number : 410-730-0161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2016
Last Update Date : 03/21/2024

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Directions to “ OGECHUKWU IMONUGO DPM” Practice Location

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