Provider Demographics
NPI:1235667270
Name:IHEZIE, ONYEKACHUKWU ADA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ONYEKACHUKWU
Middle Name:ADA
Last Name:IHEZIE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ONYEKACHUKWU
Other - Middle Name:ADA
Other - Last Name:IFEJIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1017 KINGS TREE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1221 MERCANTILE LN
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5374
Practice Address - Country:US
Practice Address - Phone:301-618-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD215571835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care