Provider Demographics
NPI:1427363670
Name:RAYMOND NWADIUKO MD,PA
Entity Type:Organization
Organization Name:RAYMOND NWADIUKO MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWADIUKO
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:301-552-4100
Mailing Address - Street 1:9831 GREENBELT RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2202
Mailing Address - Country:US
Mailing Address - Phone:301-552-4100
Mailing Address - Fax:301-552-1700
Practice Address - Street 1:9831 GREENBELT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2202
Practice Address - Country:US
Practice Address - Phone:301-552-4100
Practice Address - Fax:301-552-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0042749207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty