Provider Demographics
NPI:1093068389
Name:ASOEGWU, OKEOMA
Entity Type:Individual
Prefix:
First Name:OKEOMA
Middle Name:
Last Name:ASOEGWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4857 SAINT BARNABAS RD APT 8
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4652
Mailing Address - Country:US
Mailing Address - Phone:240-550-8548
Mailing Address - Fax:
Practice Address - Street 1:4857 SAINT BARNABAS RD APT 8
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-4652
Practice Address - Country:US
Practice Address - Phone:240-550-8548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide