Provider Demographics
NPI:1669477253
Name:OHORA, NEIL R (DPM)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:R
Last Name:OHORA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:18111 PRINCE PHILLIP DR
Mailing Address - Street 2:S-212
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:301-774-1200
Mailing Address - Fax:301-774-5820
Practice Address - Street 1:18111 PRINCE PHILLIP DR
Practice Address - Street 2:S-212
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1513
Practice Address - Country:US
Practice Address - Phone:301-774-1200
Practice Address - Fax:301-774-5820
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD0995213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD477888000Medicaid
MD477888000Medicaid
MD517797Medicare PIN