Provider Demographics
NPI:1518304476
Name:INYAMAH-OSIJO, NWAKAEGO P (MD)
Entity Type:Individual
Prefix:
First Name:NWAKAEGO
Middle Name:P
Last Name:INYAMAH-OSIJO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NWAKAEGO
Other - Middle Name:P
Other - Last Name:INYAMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4552 EMPIRE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-1939
Mailing Address - Country:US
Mailing Address - Phone:540-361-4779
Mailing Address - Fax:540-604-9893
Practice Address - Street 1:4552 EMPIRE CT
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-1939
Practice Address - Country:US
Practice Address - Phone:540-361-4779
Practice Address - Fax:540-604-9893
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
VA0101260039208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program