Provider Demographics
NPI:1619210598
Name:WHEAT, CHIKOTI MIBENGE (MD)
Entity Type:Individual
Prefix:
First Name:CHIKOTI
Middle Name:MIBENGE
Last Name:WHEAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:877 BALTIMORE ANNAPOLIS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4701
Mailing Address - Country:US
Mailing Address - Phone:410-384-9311
Mailing Address - Fax:
Practice Address - Street 1:7671 QUARTERFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4407
Practice Address - Country:US
Practice Address - Phone:443-351-3376
Practice Address - Fax:410-582-9155
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0082849207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology