Provider Demographics
NPI:1790718989
Name:ONEJEME, CHINWUBA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINWUBA
Middle Name:
Last Name:ONEJEME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TOKAY CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-3729
Mailing Address - Country:US
Mailing Address - Phone:410-655-5234
Mailing Address - Fax:
Practice Address - Street 1:4 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-869-0100
Practice Address - Fax:410-869-0460
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
9245303001OtherCIGNA
0009OtherCAREFIRST DC
281942OtherMAMSI
MD0403525Medicaid
7011107OtherAETNA PPO
035997OtherJOHNS HOPKINS HEALTHCARE
12478OtherKAISER
2328439OtherAETNA HMO
112609OtherCOVENTRY
198941OtherUNITED HEALTHCARE
700240OtherNCPPO
41877602OtherCAREFIRST MARYLAND
281942OtherMAMSI
198941OtherUNITED HEALTHCARE
MD93087Medicare ID - Type UnspecifiedAMERIGROUP