Provider Demographics
NPI:1194041780
Name:INCLUSIVE HEALTH CORPORATION
Entity Type:Organization
Organization Name:INCLUSIVE HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IKECHI
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:OKWARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-313-0600
Mailing Address - Street 1:12200 ANNAPOLIS RD STE 316
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9182
Mailing Address - Country:US
Mailing Address - Phone:301-313-0600
Mailing Address - Fax:301-313-0603
Practice Address - Street 1:12200 ANNAPOLIS RD STE 316
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9182
Practice Address - Country:US
Practice Address - Phone:301-313-0600
Practice Address - Fax:301-313-0603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD43351207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF71230Medicare UPIN