Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | M34279 | MD |
NPI | 1255387288 |
---|---|
Provider Name | Dr. Raymond O Nwadiuko |
First Address | Lanham, MD 20706-2202 |
Second Address | Lanham, MD 20706-2202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 15/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
522090806 | TAX ID (01) | MD |
F46263 | (02) | MD |