Healthcare Provider Details

I. General information

NPI: 1871409045
Provider Name (Legal Business Name): CHIAMAKA OBIDIGBO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14955 SHADY GROVE RD STE 230
ROCKVILLE MD
20850-8701
US

IV. Provider business mailing address

10914 GEORGIA AVE APT 531
SILVER SPRING MD
20902-4419
US

V. Phone/Fax

Practice location:
  • Phone: 301-984-6594
  • Fax:
Mailing address:
  • Phone: 862-250-1161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number31023
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: