Individual
DR. NGOZI RUTH AGWUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5084 DORSEY HALL DR, SUITE 104, ELLICOTT CITY, MD 21042-7711
(410) 772-9463
(410) 992-3509
Mailing address
5084 DORSEY HALL DR, SUITE 104, ELLICOTT CITY, MD 21042-7711
(410) 772-9463
(410) 992-3509
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D0044795
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128051100
—
MD
01
—
522027939
FEIN
MD
Enumeration date
08/23/2005
Last updated
10/10/2018
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