Provider Demographics
NPI:1841989233
Name:ONUKOGU, RAYMOND CHIKADIBIA (PMHNP)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:CHIKADIBIA
Last Name:ONUKOGU
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 ORPIN RD APT 102
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2473
Mailing Address - Country:US
Mailing Address - Phone:443-909-4407
Mailing Address - Fax:
Practice Address - Street 1:9616 ORPIN RD APT 102
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2473
Practice Address - Country:US
Practice Address - Phone:443-909-4407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR207863363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health