Healthcare Provider Details

I. General information

NPI: 1285544288
Provider Name (Legal Business Name): LYDIA ONYIMA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 OPOSSUMTOWN PIKE
FREDERICK MD
21702-4337
US

IV. Provider business mailing address

1562 OPOSSUMTOWN PIKE
FREDERICK MD
21702-4337
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberR215024
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: