Provider Demographics
NPI:1477578979
Name:EGBUONU, DONALD CHUKWUEMEKA (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CHUKWUEMEKA
Last Name:EGBUONU
Suffix:
Gender:M
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13612 TREE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4205
Mailing Address - Country:US
Mailing Address - Phone:301-627-5666
Mailing Address - Fax:
Practice Address - Street 1:3001 HOSPITAL DR
Practice Address - Street 2:MT WASHINGTON PEDS HOSPITAL, 6TH FLOOR PGHC
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1189
Practice Address - Country:US
Practice Address - Phone:301-618-3864
Practice Address - Fax:301-772-3166
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048202208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
490036Medicare ID - Type Unspecified
G45274Medicare UPIN