Provider Demographics
NPI:1144377490
Name:NWODIM, OKECHUKWU A (DO)
Entity Type:Individual
Prefix:
First Name:OKECHUKWU
Middle Name:A
Last Name:NWODIM
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:8116 GOOD LUCK RD
Mailing Address - Street 2:STE 305
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3502
Mailing Address - Country:US
Mailing Address - Phone:301-868-0150
Mailing Address - Fax:301-868-0243
Practice Address - Street 1:7700 OLD BRANCH AVE
Practice Address - Street 2:STE B201
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1628
Practice Address - Country:US
Practice Address - Phone:301-868-0150
Practice Address - Fax:301-868-0243
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MDH0058158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine