Provider Demographics
NPI:1992126445
Name:OWUAMANAM, CHINEMEZI MAURICE
Entity type:Individual
Prefix:
First Name:CHINEMEZI
Middle Name:MAURICE
Last Name:OWUAMANAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 MANTON WAY
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2487
Mailing Address - Country:US
Mailing Address - Phone:240-838-8333
Mailing Address - Fax:
Practice Address - Street 1:6506 MANTON WAY
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2487
Practice Address - Country:US
Practice Address - Phone:240-838-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator