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Individual

KELECHI EGO-OSUALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5305 KENILWORTH AVE, RIVERDALE, MD 20737-3101
(301) 277-7110
Mailing address
5305 KENILWORTH AVE, RIVERDALE, MD 20737-3101

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0095010
MD

Other

Enumeration date
05/18/2019
Last updated
09/03/2022
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