Provider Demographics
NPI:1699507228
Name:AVANTE ORTHO
Entity type:Organization
Organization Name:AVANTE ORTHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHAMEFULA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-302-1475
Mailing Address - Street 1:11140 ROCKVILLE PIKE STE 100-232
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3106
Mailing Address - Country:US
Mailing Address - Phone:202-302-1475
Mailing Address - Fax:
Practice Address - Street 1:8824 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2338
Practice Address - Country:US
Practice Address - Phone:202-302-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty