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General NPI Number Information
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NPI Number | 1598416869
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Entity Type | Individual
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Provider Name | DR. CHINECHEBEM JUDE-ANTHONY AMECHI
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Gender | Male
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 1332 LONDONTOWN BLVD
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City | ELDERSBURG
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State | MD
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Zip | 21784-6587
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Country | US
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Telephone | 410-989-3833
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Fax |
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Provider Business Mailing Address
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Address Line | 5809 COMSTOCK AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-2214
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Country | US
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Telephone | 443-500-2569
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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