Provider Demographics
NPI:1780926568
Name:OZOUDE, CHIZOBA GODWIN
Entity type:Individual
Prefix:MR
First Name:CHIZOBA
Middle Name:GODWIN
Last Name:OZOUDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 WINDING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2515
Mailing Address - Country:US
Mailing Address - Phone:240-646-4579
Mailing Address - Fax:
Practice Address - Street 1:2440 WINDING RIDGE RD
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2515
Practice Address - Country:US
Practice Address - Phone:240-646-4579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA1500374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide