Healthcare Provider Details

I. General information

NPI: 1235155441
Provider Name (Legal Business Name): VICTORIA O OSHODI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 PENNSYLVANIA AVENUE SE
WASHINGTON DC
20003
US

IV. Provider business mailing address

2811 LORD BALTIMORE DR
BALTIMORE MD
21244
US

V. Phone/Fax

Practice location:
  • Phone: 202-547-0956
  • Fax: 202-547-1065
Mailing address:
  • Phone: 443-316-2101
  • Fax: 410-265-6068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP640
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: