Provider Demographics
NPI:1326148412
Name:OHANENYE, STELLA CHIDI (OD)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:CHIDI
Last Name:OHANENYE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STELLA
Other - Middle Name:CHIDI
Other - Last Name:MBAKWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:75 N EAST RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-3613
Mailing Address - Country:US
Mailing Address - Phone:410-287-3723
Mailing Address - Fax:
Practice Address - Street 1:75 N EAST RD
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:MD
Practice Address - Zip Code:21901-3613
Practice Address - Country:US
Practice Address - Phone:410-287-3723
Practice Address - Fax:410-287-3826
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1808152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist