Provider Demographics
NPI:1467015990
Name:OMADJELA, OTSHUMBA RACHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:OTSHUMBA
Middle Name:RACHELLE
Last Name:OMADJELA
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3806 MECHANICSVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1114
Mailing Address - Country:US
Mailing Address - Phone:804-228-1143
Mailing Address - Fax:804-554-5386
Practice Address - Street 1:3806 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1114
Practice Address - Country:US
Practice Address - Phone:804-228-1143
Practice Address - Fax:804-554-5386
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101275025207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine