Individual
IKECHI F OKWARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12200 ANNAPOLIS RD, STE 316, GLENN DALE, MD 20769-9182
(301) 313-0600
Mailing address
3815 DEEP HOLLOW WAY, BOWIE, MD 20721-1275
(301) 313-0600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D43351
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130271000
—
MD
05
—
409972900
—
MD
01
—
75859903
BLUE SHIELD
MD
01
—
P00433571
RAILROAD MED
MD
Enumeration date
06/07/2006
Last updated
11/18/2011
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