Healthcare Provider Details

I. General information

NPI: 1407228422
Provider Name (Legal Business Name): AMARACHI NWAIJE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALABAMA AVE SE
WASHINGTON DC
20032-4540
US

IV. Provider business mailing address

9729 QUIET BROOK LN
CLINTON MD
20735-3374
US

V. Phone/Fax

Practice location:
  • Phone: 202-299-5397
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMTL002892
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: