Individual
NCHEDOCHUKWU IDAHOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1576 MERRITT BLVD STE 18, DUNDALK, MD 21222-2132
(443) 693-7246
(443) 399-8309
Mailing address
2 PARK CENTER CT STE 200, OWINGS MILLS, MD 21117-4221
(443) 693-7246
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06724
MD
Other
Enumeration date
12/22/2017
Last updated
03/17/2018
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