Provider Demographics
NPI:1023243565
Name:NWANKPAH, AMARACHI E (MD)
Entity type:Individual
Prefix:
First Name:AMARACHI
Middle Name:E
Last Name:NWANKPAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:SUITE 6W PPQA
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-5853
Mailing Address - Fax:
Practice Address - Street 1:900 CATON AVE
Practice Address - Street 2:MAILBOX #081
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:443-703-3200
Practice Address - Fax:443-703-3201
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD74540207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program