MEDICARE: MR. WILSON CHIJIOKE ONWUASONYA

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	163W00000X	Registered Nurse	RN1026434	DC
2	363L00000X	Nurse Practitioner	RN1026434	DC

General Provider Information

NPI Number	:	1750784922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILSON CHIJIOKE ONWUASONYA

Provider Business Mailing Address
First Line	:	2811 NICHOLSON ST
Second Line	:	101
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-2849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2811 NICHOLSON ST
Second Line	:	101
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-2849
Country	:	US
Telephone Number	:	240-338-6435
Fax Number	:

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

Provider Enumeration Date	:	10/02/2014
Last Update Date	:	08/04/2023

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Directions to “ MR. WILSON CHIJIOKE ONWUASONYA ” Practice Location

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