Provider Demographics
NPI:1447646534
Name:OHIENMHEN, BEATRIX (MD)
Entity type:Individual
Prefix:
First Name:BEATRIX
Middle Name:
Last Name:OHIENMHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 PEMBROOKE SQ STE 110
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4806
Mailing Address - Country:US
Mailing Address - Phone:301-843-6996
Mailing Address - Fax:
Practice Address - Street 1:900 TOWNE LAKE PKWY STE 306
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1604
Practice Address - Country:US
Practice Address - Phone:770-852-7720
Practice Address - Fax:770-852-7721
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA82981208000000X
MDD0085509208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics