Provider Demographics
NPI:1619289386
Name:NWOGA, OBIANUJU GERALDINE (MD)
Entity type:Individual
Prefix:MRS
First Name:OBIANUJU
Middle Name:GERALDINE
Last Name:NWOGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:903 RUSSELL AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3257
Mailing Address - Country:US
Mailing Address - Phone:301-869-2292
Mailing Address - Fax:301-869-4223
Practice Address - Street 1:11161 NEW HAMPSHIRE AVE STE 301
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2606
Practice Address - Country:US
Practice Address - Phone:301-681-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2024-09-12
Deactivation Date:2023-05-23
Deactivation Code:
Reactivation Date:2023-06-09
Provider Licenses
StateLicense IDTaxonomies
MDD0082106208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics