Provider Demographics
NPI:1861794240
Name:ONYIMBA, FIDELIS IFEANYI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:FIDELIS
Middle Name:IFEANYI
Last Name:ONYIMBA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 CLOUDLEAP CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3044
Mailing Address - Country:US
Mailing Address - Phone:301-596-5027
Mailing Address - Fax:301-596-4857
Practice Address - Street 1:8775 CLOUDLEAP CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3044
Practice Address - Country:US
Practice Address - Phone:301-596-5027
Practice Address - Fax:301-596-4857
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist