Organization
CHIVIC HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NDIDIAMAKA EZINNE MBAKPUO (CEO)
(301) 712-4637
Entity
Organization
Contact information
Practice address
9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
(202) 735-1010
Mailing address
9470 ANNAPOLIS RD STE 416, LANHAM, MD 20706-3000
(202) 735-1010
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/07/2023
Last updated
09/05/2023
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