Provider Demographics
NPI:1588747422
Name:AMAZU, CHINYERE ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:CHINYERE
Middle Name:ROSE
Last Name:AMAZU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHINYERE
Other - Middle Name:ROSE
Other - Last Name:AMAZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9500 ANNAPOLIS RD.
Mailing Address - Street 2:B-7
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2080
Mailing Address - Country:US
Mailing Address - Phone:301-429-5866
Mailing Address - Fax:301-429-8818
Practice Address - Street 1:9500 ANNAPOLIS RD STE B7
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2080
Practice Address - Country:US
Practice Address - Phone:301-429-5866
Practice Address - Fax:301-429-8818
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 30822208000000X
MDD0050340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC34954200Medicaid
MD121325300Medicaid
DC34954200Medicaid