Provider Demographics
NPI:1194940833
Name:EBEREONWU, IJEOMA ROPHINA (DPT)
Entity type:Individual
Prefix:MS
First Name:IJEOMA
Middle Name:ROPHINA
Last Name:EBEREONWU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:IJEOMA
Other - Middle Name:ROPHINA
Other - Last Name:IWUMUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2 BRANTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-7941
Mailing Address - Country:US
Mailing Address - Phone:410-882-6198
Mailing Address - Fax:
Practice Address - Street 1:2 BRANTWOOD CT
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-7941
Practice Address - Country:US
Practice Address - Phone:410-882-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20251171400000X, 171M00000X, 225400000X, 251E00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No251E00000XAgenciesHome Health