Healthcare Provider Details

I. General information

NPI: 1932606753
Provider Name (Legal Business Name): IFUNANYA ROSEMARY KALU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IFUNANYA ROSEMARY UZOMAH

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20059-0001
US

IV. Provider business mailing address

2041 GEORGIA AVE NW
WASHINGTON DC
20059-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-4833
  • Fax: 202-865-1773
Mailing address:
  • Phone: 202-865-4833
  • Fax: 202-865-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD92067
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD92067
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: