Provider Demographics
NPI:1316788342
Name:ANYANWU, ODIRICHINMA JANICE
Entity type:Individual
Prefix:
First Name:ODIRICHINMA
Middle Name:JANICE
Last Name:ANYANWU
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 1:1577 LUXTON ST
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-5035
Mailing Address - Country:US
Mailing Address - Phone:667-276-8201
Mailing Address - Fax:
Practice Address - Street 1:131 INDUSTRY LN
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1777
Practice Address - Country:US
Practice Address - Phone:667-276-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program