Healthcare Provider Details

I. General information

NPI: 1689198350
Provider Name (Legal Business Name): CHIEDOZIE OBINNA OJIMBA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10632 LITTLE PATUXENT PKWY STE 249
COLUMBIA MD
21044-6206
US

IV. Provider business mailing address

10632 LITTLE PATUXENT PKWY STE 249
COLUMBIA MD
21044-6206
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-0774
  • Fax: 410-772-0776
Mailing address:
  • Phone: 410-772-0774
  • Fax: 410-772-0776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0093357
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2100019
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number305497
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberMD2100019
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberD0093357
License Number StateMD
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD210001976
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: