Healthcare Provider Details

I. General information

NPI: 1548292808
Provider Name (Legal Business Name): CHIDEHA MACDONALD OHUOHA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 26TH AVE
TEMPLE HILLS MD
20748-3010
US

IV. Provider business mailing address

3704 26TH AVE
TEMPLE HILLS MD
20748-3010
US

V. Phone/Fax

Practice location:
  • Phone: 301-630-4009
  • Fax: 301-630-6916
Mailing address:
  • Phone: 301-630-4009
  • Fax: 301-630-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberDO46159-PSYCHIATRY
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD46159
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: