Healthcare Provider Details

I. General information

NPI: 1083280952
Provider Name (Legal Business Name): OYIYECHUKWU ONWUDIWE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 FAIRMOUNT AVE STE 320
TOWSON MD
21286-5466
US

IV. Provider business mailing address

515 FAIRMOUNT AVE STE 400
TOWSON MD
21286-8518
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-0497
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0106531
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: