Provider Demographics
NPI:1124373642
Name:OBICHERE, NDIDI (DO)
Entity Type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:
Last Name:OBICHERE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SINCLAIR LANE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2037
Mailing Address - Country:US
Mailing Address - Phone:410-762-8800
Mailing Address - Fax:410-534-2392
Practice Address - Street 1:3700 FLEET ST
Practice Address - Street 2:STE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4200
Practice Address - Country:US
Practice Address - Phone:410-558-4900
Practice Address - Fax:410-522-5070
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20010184207Q00000X
MDH75358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine