Provider Demographics
NPI:1376822163
Name:OMOIKE, OYAKHILOMEN (D SCI, MSPT)
Entity type:Individual
Prefix:DR
First Name:OYAKHILOMEN
Middle Name:
Last Name:OMOIKE
Suffix:
Gender:M
Credentials:D SCI, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 OXBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3115
Mailing Address - Country:US
Mailing Address - Phone:202-492-4233
Mailing Address - Fax:
Practice Address - Street 1:9616 OXBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-3115
Practice Address - Country:US
Practice Address - Phone:202-492-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 2251X0800X
DC8700662251X0800X
MD199332251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic