Organization
EFEM IMOKE, M.D., P.A.
Active
Other names
UNIVERSAL SURGICAL ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL LYN CWIK (DIRECTOR OF ADMINISTRATIVE AFFAIRS)
(410) 247-4740
Entity
Organization
Contact information
Practice address
4713 LEEDS AVE, BALTIMORE, MD 21227-1402
(410) 247-4740
(410) 247-2346
Mailing address
4713 LEEDS AVE, BALTIMORE, MD 21227-1402
(410) 247-4740
(410) 247-2346
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0025902
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920541100
—
MD
Enumeration date
10/17/2007
Last updated
10/28/2009
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