Individual
SANDRA OGBONNAYA-WHITTLESEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-7168
Mailing address
10 CENTER DR BLDG 10, BETHESDA, MD 20892-0001
(301) 496-2626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A122336
CA
208000000X
Pediatrics Physician
A122336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114061
SID # 114061
CA
01
—
MD049279
DC MEDICAL LICENSE
DC
Enumeration date
02/24/2012
Last updated
09/08/2022
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