Provider Demographics
NPI:1841086329
Name:IBEGWAM, IJEOMA CHIKA (MARYLAND)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:CHIKA
Last Name:IBEGWAM
Suffix:
Gender:F
Credentials:MARYLAND
Other - Prefix:
Other - First Name:IJEOMA
Other - Middle Name:CHIKA
Other - Last Name:IBEGWAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARYLAND
Mailing Address - Street 1:11713 TUSCANY DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2844
Mailing Address - Country:US
Mailing Address - Phone:301-693-1671
Mailing Address - Fax:
Practice Address - Street 1:11713 TUSCANY DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2844
Practice Address - Country:US
Practice Address - Phone:301-693-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR188483163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse