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General NPI Number Information
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NPI Number | 1740235076
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Entity Type | Individual
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Provider Name | CHINEDUM IKEMEFUNA OLISEMEKA DO
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 01/05/2020
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Provider Practice Location Address
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Address Line | 15215 SHADY GROVE RD STE. 100
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City | ROCKVILLE
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State | MD
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Zip | 20850-3235
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Country | US
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Telephone | 301-519-0902
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Fax | 301-519-0905
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Provider Business Mailing Address
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Address Line | 15215 SHADY GROVE RD STE 100
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City | ROCKVILLE
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State | MD
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Zip | 20850-3235
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Country | US
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Telephone | 301-519-0902
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | L7508
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0102202305
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | H67639
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License Number State | MD
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