Healthcare Provider Details

I. General information

NPI: 1306268701
Provider Name (Legal Business Name): CHINELO ENWONWU PHARMD,MPH,CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2014
Last Update Date: 03/11/2022
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 40TH ST NE
WASHINGTON DC
20019-3372
US

IV. Provider business mailing address

6518 CHINA GROVE CT
ALEXANDRIA VA
22310-2430
US

V. Phone/Fax

Practice location:
  • Phone: 202-396-2331
  • Fax:
Mailing address:
  • Phone: 216-288-9655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number13693
License Number State
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202211247
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH100001022
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: