Healthcare Provider Details

I. General information

NPI: 1447659222
Provider Name (Legal Business Name): MRS. CHINYERE CHINWE OPAIGBEOGU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SERO PINE LN
FORT WASHINGTON MD
20744-5920
US

IV. Provider business mailing address

801 SERO PINE LN
FORT WASHINGTON MD
20744-5920
US

V. Phone/Fax

Practice location:
  • Phone: 240-838-6143
  • Fax:
Mailing address:
  • Phone: 240-838-6143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18539
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: