Provider Demographics
NPI:1346390234
Name:NWOKORIE, NDIDI NNALU (MBBS)
Entity Type:Individual
Prefix:DR
First Name:NDIDI
Middle Name:NNALU
Last Name:NWOKORIE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:DR
Other - First Name:NDIDI
Other - Middle Name:NNALU
Other - Last Name:UKEJIANYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 MORNING MIST CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1019
Mailing Address - Country:US
Mailing Address - Phone:410-496-8230
Mailing Address - Fax:
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052173207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD75859901OtherBLUE SHIELD
MD75859901OtherBLUE SHIELD
MDF72316Medicare UPIN