Individual
DR. LAURETTA IFEOMA ODOGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007
(202) 444-3976
Mailing address
3800 RESERVOIR RD NW, WASHINGTON, DC 20007-2113
(202) 444-3976
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200300511
NC
207R00000X
Internal Medicine Physician
Primary
MD31679
DC
207RX0202X
Medical Oncology Physician
200300511
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346A
BCBS NC
NC
01
—
3953934
AETNA
NC
01
—
803556
PARTNERS MEDICARE
NC
05
—
891346A
—
NC
01
—
E3248
MEDCOST
NC
Enumeration date
05/18/2006
Last updated
10/18/2019
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