Provider Demographics
NPI:1720487341
Name:ANYANWU, CHIKA
Entity Type:Individual
Prefix:
First Name:CHIKA
Middle Name:
Last Name:ANYANWU
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 1:3611 BLADENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLMAR MANOR
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1809
Mailing Address - Country:US
Mailing Address - Phone:301-277-6667
Mailing Address - Fax:301-277-1897
Practice Address - Street 1:3611 BLADENSBURG RD
Practice Address - Street 2:
Practice Address - City:COLMAR MANOR
Practice Address - State:MD
Practice Address - Zip Code:20722-1809
Practice Address - Country:US
Practice Address - Phone:301-277-6667
Practice Address - Fax:301-277-1897
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19095183500000X
DCPH100001534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist