Healthcare Provider Details

I. General information

NPI: 1245177740
Provider Name (Legal Business Name): IFEYINWA AKWARANDU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

6400 HOMESTAKE DR S
BOWIE MD
20720-4600
US

V. Phone/Fax

Practice location:
  • Phone: 301-978-1319
  • Fax:
Mailing address:
  • Phone: 301-978-1319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR239247
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: