Healthcare Provider Details

I. General information

NPI: 1538561824
Provider Name (Legal Business Name): MR. EMMANUEL NJOKU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 BIRDSEYE LN
BOWIE MD
20715-3932
US

IV. Provider business mailing address

5870 SILVER HILL RD
DISTRICT HEIGHTS MD
20747-1103
US

V. Phone/Fax

Practice location:
  • Phone: 301-996-1221
  • Fax:
Mailing address:
  • Phone: 301-736-3994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13839
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: