Provider Demographics
NPI:1033009568
Name:OSUEBI, ANSELEM IKECHUKWU
Entity type:Individual
Prefix:
First Name:ANSELEM
Middle Name:IKECHUKWU
Last Name:OSUEBI
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 1:9548 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4010
Mailing Address - Country:US
Mailing Address - Phone:404-396-0913
Mailing Address - Fax:
Practice Address - Street 1:9548 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4010
Practice Address - Country:US
Practice Address - Phone:404-396-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty