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Individual

CHARLES TIKU EKOKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NURSE

Contact information

Practice address
2109 WATERLEAF WAY, BOWIE, MD 20721-2276
(240) 461-9241
Mailing address
2109 WATERLEAF WAY, BOWIE, MD 20721-2276
(240) 461-9241

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP26714
MD

Other

Enumeration date
09/26/2014
Last updated
09/26/2014
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