MEDICARE: DR. DESMOND UWADIALE OHIOWELE M.D

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
1	208600000X	Surgery Physician	ML60370499	WA
2	208600000X	Surgery Physician	MD60577638	WA
3	208D00000X	General Practice Physician	MD60577638	WA

General Provider Information

NPI Number	:	1679916092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DESMOND UWADIALE OHIOWELE M.D

Provider Business Mailing Address
First Line	:	2041 GEORGIA AVE NW WASHINGTON DC 20059
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20059-0001
Country	:	US
Telephone Number	:	202-865-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 GEORGIA AVE NW WASHINGTON DC 20059
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20059-6410
Country	:	US
Telephone Number	:	202-865-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2013
Last Update Date	:	06/03/2021

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