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Individual

NGOZI EZINNE NWAKAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 532-4396
(410) 532-4791
Mailing address
9468 JOPPA POND RD, BALTIMORE, MD 21234-1362
(410) 256-4493

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0002664
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C0002664
STATE LICENSE NUMBER
MD
Enumeration date
05/03/2007
Last updated
10/23/2007
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