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General NPI Number Information
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NPI Number | 1164052692
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Entity Type | Individual
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Provider Name | GREGORY ANYINAM OBIWUMA PMHNP
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Gender | Male
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1818 NEW YORK AVE NE STE 233
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City | WASHINGTON
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State | DC
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Zip | 20002-1848
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Country | US
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Telephone | 202-706-4428
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Fax | 800-648-0573
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Provider Business Mailing Address
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Address Line | 1818 NEW YORK AVE NE STE 233
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City | WASHINGTON
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State | DC
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Zip | 20002-1848
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Country | US
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Telephone | 202-706-4428
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Fax | 800-648-0573
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP1016444
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN1016444
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License Number State | DC
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