Provider Demographics
NPI:1194335661
Name:UMUNNAKWE, CHINOMSO J
Entity type:Individual
Prefix:
First Name:CHINOMSO
Middle Name:J
Last Name:UMUNNAKWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHINOMSO
Other - Middle Name:J
Other - Last Name:UMUNNAKWE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3821 E JOPPA RD APT B2
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2375
Mailing Address - Country:US
Mailing Address - Phone:443-682-3497
Mailing Address - Fax:
Practice Address - Street 1:1238 PUTTY HILL AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5844
Practice Address - Country:US
Practice Address - Phone:410-823-4543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist