Provider Demographics
NPI:1861246258
Name:IJOMAH, CHRISTOPHER ONYEBUCHI
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ONYEBUCHI
Last Name:IJOMAH
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 1:1205 ASHLEIGH STATION CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-6005
Mailing Address - Country:US
Mailing Address - Phone:302-650-3755
Mailing Address - Fax:
Practice Address - Street 1:1205 ASHLEIGH STATION CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-6005
Practice Address - Country:US
Practice Address - Phone:302-650-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker