Provider Demographics
NPI:1508602673
Name:ONWUDIEGWU, EKWY
Entity type:Individual
Prefix:
First Name:EKWY
Middle Name:
Last Name:ONWUDIEGWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EKWUTOSI
Other - Middle Name:J
Other - Last Name:ONWUDIEGWU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10322 HALTON TER
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2374
Mailing Address - Country:US
Mailing Address - Phone:301-213-1424
Mailing Address - Fax:
Practice Address - Street 1:721 48TH ST NE # EAST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3607
Practice Address - Country:US
Practice Address - Phone:202-541-9844
Practice Address - Fax:202-541-9845
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR129521163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse