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General NPI Number Information
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NPI Number | 1285946210
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Entity Type | Organization
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Legal Business Name | CHIKA EYE CARE LLC
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 122 SMALLWOOD VILLAGE CTR
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City | WALDORF
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State | MD
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Zip | 20602-1843
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Country | US
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Telephone | 240-419-3846
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Fax | 240-419-3854
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Provider Business Mailing Address
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Address Line | 122 SMALLWOOD VILLAGE CTR
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City | WALDORF
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State | MD
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Zip | 20602-1843
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Country | US
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Telephone | 240-419-3846
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Fax | 240-419-3854
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHIKA OJUKWU
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Credential | OD
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Telephone | 240-419-3846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | X48488
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License Number State | MD
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