Provider Demographics
NPI:1912174863
Name:OGBEMUDIA, MOSES OSAZUWA (DC)
Entity Type:Individual
Prefix:DR
First Name:MOSES
Middle Name:OSAZUWA
Last Name:OGBEMUDIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 L ST NW
Mailing Address - Street 2:SUITE 503
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5002
Mailing Address - Country:US
Mailing Address - Phone:202-627-2885
Mailing Address - Fax:202-735-5412
Practice Address - Street 1:1900 L ST NW
Practice Address - Street 2:SUITE 503
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5002
Practice Address - Country:US
Practice Address - Phone:202-626-2885
Practice Address - Fax:202-735-5412
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU86947Medicare UPIN