Provider Demographics
NPI:1063920098
Name:NWOGU, EUCHARIA
Entity type:Individual
Prefix:
First Name:EUCHARIA
Middle Name:
Last Name:NWOGU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 BEETHOVEN WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6860
Mailing Address - Country:US
Mailing Address - Phone:301-847-0779
Mailing Address - Fax:
Practice Address - Street 1:3104 BEETHOVEN WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6860
Practice Address - Country:US
Practice Address - Phone:301-847-0779
Practice Address - Fax:301-847-0779
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-11
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR144091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty