Healthcare Provider Details

I. General information

NPI: 1134929011
Provider Name (Legal Business Name): SUSAN KAMARACHUKWUME IHEKWEME AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11119 ROCKVILLE PIKE STE 210
ROCKVILLE MD
20852-3200
US

IV. Provider business mailing address

18310 MONTGOMERY VILLAGE AVE STE 520
GAITHERSBURG MD
20879-3554
US

V. Phone/Fax

Practice location:
  • Phone: 301-468-3977
  • Fax: 301-468-3978
Mailing address:
  • Phone: 301-977-6317
  • Fax: 301-977-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: