Healthcare Provider Details

I. General information

NPI: 1407596364
Provider Name (Legal Business Name): CHIMA ERASMUS ONYEGBULE MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

IV. Provider business mailing address

901 HARRY S TRUMAN DR N
LARGO MD
20774-5477
US

V. Phone/Fax

Practice location:
  • Phone: 240-677-1000
  • Fax:
Mailing address:
  • Phone: 240-677-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0101876
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: