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Organization

ELITE MED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHIOMA UDEMGBA MD (OWNER, CHIEF CLINICAL OFFICER)
(202) 642-9233
Entity
Organization

Contact information

Practice address
715 H ST NE, SUITE 2569, WASHINGTON, DC 20002
(202) 642-9233
Mailing address
715 H ST NE, SUITE 2569, WASHINGTON, DC 20002
(202) 642-9233

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171400000X
Health & Wellness Coach
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician
225700000X
Massage Therapist
363L00000X
Nurse Practitioner
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
09/12/2023
Last updated
09/12/2023
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