Healthcare Provider Details

I. General information

NPI: 1578400537
Provider Name (Legal Business Name): EZIAKU IHUOMA OGBONNA PHARMD, BCPS, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W 24TH ST
BALTIMORE MD
21218-5001
US

IV. Provider business mailing address

11016 PARK HEIGHTS AVE
OWINGS MILLS MD
21117-3021
US

V. Phone/Fax

Practice location:
  • Phone: 443-602-7925
  • Fax:
Mailing address:
  • Phone: 301-532-2803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20874
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: