Healthcare Provider Details

I. General information

NPI: 1588747422
Provider Name (Legal Business Name): CHINYERE ROSE AMAZU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHINYERE ROSE AMAZU M.D.

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 ANNAPOLIS RD STE B7
LANHAM MD
20706-2080
US

IV. Provider business mailing address

9500 ANNAPOLIS RD. B-7
LANHAM MD
20706-2080
US

V. Phone/Fax

Practice location:
  • Phone: 301-429-5866
  • Fax: 301-429-8818
Mailing address:
  • Phone: 301-429-5866
  • Fax: 301-429-8818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 30822
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0050340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: