Provider Demographics
NPI:1538167028
Name:OKIGBO, NNENNA IHUOMA (MD)
Entity type:Individual
Prefix:DR
First Name:NNENNA
Middle Name:IHUOMA
Last Name:OKIGBO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11161 NEW HAMPSHIRE AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2606
Mailing Address - Country:US
Mailing Address - Phone:301-592-0062
Mailing Address - Fax:301-592-0300
Practice Address - Street 1:11161 NEW HAMPSHIRE AVE STE 305
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2606
Practice Address - Country:US
Practice Address - Phone:301-592-0062
Practice Address - Fax:301-592-0300
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405078900Medicaid
I13422Medicare UPIN
DC016703M58Medicare PIN
G01921P01Medicare ID - Type Unspecified