Provider Demographics
NPI:1285365627
Name:NWOZUZU, MAXIMUS CHINEMERE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MAXIMUS
Middle Name:CHINEMERE
Last Name:NWOZUZU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 BLADENSBURG RD NE APT 602
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2696
Mailing Address - Country:US
Mailing Address - Phone:917-257-2434
Mailing Address - Fax:
Practice Address - Street 1:2820 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4412
Practice Address - Country:US
Practice Address - Phone:703-521-3143
Practice Address - Fax:703-521-3280
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist