Provider Demographics
NPI:1669176897
Name:ONUORAH, KINGSLEY AZUBUIKE
Entity type:Individual
Prefix:MR
First Name:KINGSLEY
Middle Name:AZUBUIKE
Last Name:ONUORAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUDBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4118
Mailing Address - Country:US
Mailing Address - Phone:443-453-3414
Mailing Address - Fax:
Practice Address - Street 1:7 SUDBROOK LN
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4118
Practice Address - Country:US
Practice Address - Phone:410-486-8771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR238017363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health