Provider Demographics
NPI:1447655311
Name:CHIMAROKE, NNAMDI ZIMUZOCHUKWU
Entity type:Individual
Prefix:
First Name:NNAMDI
Middle Name:ZIMUZOCHUKWU
Last Name:CHIMAROKE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 CRESTLINE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1429
Mailing Address - Country:US
Mailing Address - Phone:301-804-8172
Mailing Address - Fax:
Practice Address - Street 1:1513 CRESTLINE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1429
Practice Address - Country:US
Practice Address - Phone:301-804-8172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA10968374U00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide