Provider Demographics
NPI:1922605104
Name:IWUOHA, RITA UZOAMAKA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:UZOAMAKA
Last Name:IWUOHA
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 1:6315 LANDOVER RD APT 104
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1316
Mailing Address - Country:US
Mailing Address - Phone:240-478-2497
Mailing Address - Fax:
Practice Address - Street 1:6315 LANDOVER RD APT 104
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1316
Practice Address - Country:US
Practice Address - Phone:240-478-2497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00171932251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2404782497Medicaid