MEDICARE: DOMINIC SUNDAY ONWUKWE OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA 1912	MD
2	152W00000X	Optometrist	OP1000012	DC

General Provider Information

NPI Number	:	1508953225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIC SUNDAY ONWUKWE OD

Provider Business Mailing Address
First Line	:	2451 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3403
Country	:	US
Telephone Number	:	202-627-2403
Fax Number	:	202-627-2428

Provider Business Practice Location Address
First Line	:	2451 GOOD HOPE RD SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-3203
Country	:	US
Telephone Number	:	202-627-2403
Fax Number	:	202-627-2428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	09/23/2015

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