Provider Demographics
NPI:1881765170
Name:NWANKWO, CHRISTIAN NNAMDI JR (MD, MPH, FAAFP)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:NNAMDI
Last Name:NWANKWO
Suffix:JR
Gender:M
Credentials:MD, MPH, FAAFP
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Mailing Address - Street 1:17 FIRSTFIELD RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1774
Mailing Address - Country:US
Mailing Address - Phone:301-977-9077
Mailing Address - Fax:301-977-0402
Practice Address - Street 1:17 FIRSTFIELD RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1774
Practice Address - Country:US
Practice Address - Phone:301-977-9077
Practice Address - Fax:301-977-0402
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2024-11-12
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Provider Licenses
StateLicense IDTaxonomies
MDD44239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD146781601Medicaid
MDF86983Medicare UPIN
MD743756Medicare ID - Type Unspecified