MEDICARE: DR. YVONNE KOYEN OKOH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0116021396	VA
2	207Q00000X	Family Medicine Physician	0101256260	VA
3	207Q00000X	Family Medicine Physician	D84196	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689801045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE KOYEN OKOH M.D.

Provider Business Mailing Address
First Line	:	1251B SARATOGA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1025
Country	:	US
Telephone Number	:	202-469-4699
Fax Number	:	301-215-4499

Provider Business Practice Location Address
First Line	:	1251B SARATOGA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1025
Country	:	US
Telephone Number	:	202-469-4699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2009
Last Update Date	:	12/05/2024

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