Individual
EZENWA DIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3801 MACCORKLE AVE SE, CHARLESTON, WV 25304-1527
(304) 925-2168
Mailing address
19 BRADFORD ST APT 308, CHARLESTON, WV 25301-3043
(304) 685-4315
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0008610
WV
Other
Enumeration date
07/19/2014
Last updated
07/19/2014
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