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General NPI Number Information
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NPI Number | 1356086755
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Entity Type | Individual
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Provider Name | NWANDO EKEZIE MD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 1920 L ST NW STE 350
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City | WASHINGTON
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State | DC
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Zip | 20036-5072
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Country | US
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Telephone | 202-296-4002
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Fax |
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Provider Business Mailing Address
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Address Line | 2072 DAVIDSON AVE
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City | BRONX
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State | NY
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Zip | 10453-3324
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Country | US
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Telephone | 347-819-6129
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101286342
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License Number State | VA
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