Healthcare Provider Details

I. General information

NPI: 1205198512
Provider Name (Legal Business Name): OGECHUKWU NDUM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18947 JOHN J WILLIAMS HWY UNIT 201
REHOBOTH BEACH DE
19971-4476
US

IV. Provider business mailing address

1515 SAVANNAH RD FL 2
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-703-3393
  • Fax: 833-448-3182
Mailing address:
  • Phone: 302-645-3499
  • Fax: 302-644-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberTMD004640
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number33542
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberC1-0029144
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0085085
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number5125-320
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: