Basic Information
| Provider Information | |||||||||
| NPI: | 1013065267 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ONWUKA | ||||||||
| FirstName: | CHIKE | ||||||||
| MiddleName: | GREGORY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9135 PISCATAWAY ROAD | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018682555 | ||||||||
| FaxNumber: | 3018682933 | ||||||||
| Practice Location | |||||||||
| Address1: | 9135 PISCATAWAY ROAD | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018682555 | ||||||||
| FaxNumber: | 3018682933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2007 | ||||||||
| LastUpdateDate: | 10/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0064986 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00856604 | 01 | DC | RAILROAD MEDICARE | OTHER | 7600 | 05 | MD | MEDICAID |