Provider Demographics
NPI:1801322797
Name:ONYEBUENYI, UWAOMA
Entity type:Individual
Prefix:
First Name:UWAOMA
Middle Name:
Last Name:ONYEBUENYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:UWAOMA
Other - Middle Name:
Other - Last Name:ONYEBUENYI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:3701 ALTA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-4053
Mailing Address - Country:US
Mailing Address - Phone:240-460-0390
Mailing Address - Fax:
Practice Address - Street 1:3701 ALTA VISTA DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-4053
Practice Address - Country:US
Practice Address - Phone:240-460-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDH1000022241835P2201X
MD240531835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care