Provider Demographics
NPI:1376822163
Name:OMOIKE, OYAKHILOMEN (DPT)
Entity Type:Individual
Prefix:DR
First Name:OYAKHILOMEN
Middle Name:
Last Name:OMOIKE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 OXBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3115
Mailing Address - Country:US
Mailing Address - Phone:202-492-4233
Mailing Address - Fax:
Practice Address - Street 1:9616 OXBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-3115
Practice Address - Country:US
Practice Address - Phone:202-492-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD199332251S0007X
DC8700662251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic