Individual
DR. ENI CLEMENT OKONOFUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.B.,B.S.
Contact information
Practice address
5390 DORCHESTER RD, NORTH CHARLESTON, SC 29418-5652
(843) 552-3099
(846) 559-9037
Mailing address
5390 DORCHESTER RD, N CHARLESTON, SC 29418-5652
(843) 552-3099
(843) 552-3277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21076
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134323946
BCBS OF SC
SC
05
—
T53518
—
SC
Enumeration date
06/19/2006
Last updated
10/01/2019
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