Provider Demographics
NPI:1003836305
Name:NWANERI, NGOZIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:NGOZIKA
Middle Name:
Last Name:NWANERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 KEMPTON RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1104
Mailing Address - Country:US
Mailing Address - Phone:301-459-6040
Mailing Address - Fax:301-731-6163
Practice Address - Street 1:7214 KEMPTON RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1104
Practice Address - Country:US
Practice Address - Phone:301-459-6040
Practice Address - Fax:301-731-6163
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC9171174400000X
MDD23145174400000X
VA0101027840174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD362761600Medicaid
DC019929600Medicaid
MD362761600Medicaid
DC019929600Medicaid