Provider Demographics
NPI:1568457687
Name:OMENKA, VERONICA CHINYELU (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:CHINYELU
Last Name:OMENKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18528 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0586
Mailing Address - Country:US
Mailing Address - Phone:301-330-4130
Mailing Address - Fax:301-330-4150
Practice Address - Street 1:18528 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-0586
Practice Address - Country:US
Practice Address - Phone:301-330-4130
Practice Address - Fax:301-330-4150
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2011-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065257208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics