Provider Demographics
NPI:1710591151
Name:ORAKWUE, ZIMUZOH
Entity Type:Individual
Prefix:
First Name:ZIMUZOH
Middle Name:
Last Name:ORAKWUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BLACKFORD DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENSON
Mailing Address - State:VA
Mailing Address - Zip Code:22656-1960
Mailing Address - Country:US
Mailing Address - Phone:347-971-5239
Mailing Address - Fax:
Practice Address - Street 1:1202 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7603
Practice Address - Country:US
Practice Address - Phone:301-729-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218959183500000X
MD27461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist