Provider Demographics
NPI:1235331786
Name:OZURUMBA, ONYEIJE WIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ONYEIJE
Middle Name:WIL
Last Name:OZURUMBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:NEW CANTON
Mailing Address - State:VA
Mailing Address - Zip Code:23123-0220
Mailing Address - Country:US
Mailing Address - Phone:434-581-4073
Mailing Address - Fax:434-581-1704
Practice Address - Street 1:4260 CROSSINGS BLVD STE 2
Practice Address - Street 2:
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875-1400
Practice Address - Country:US
Practice Address - Phone:804-452-5800
Practice Address - Fax:804-452-5801
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101246286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101246286OtherMED LICENSE #
VA0101246286OtherMED LICENSE #
VAC09633OtherGROUP PTAN