Healthcare Provider Details

I. General information

NPI: 1265915334
Provider Name (Legal Business Name): SAMUEL U OKAFOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7845 WISE AVE
DUNDALK MD
21222-3339
US

IV. Provider business mailing address

7845 WISE AVE
DUNDALK MD
21222-3339
US

V. Phone/Fax

Practice location:
  • Phone: 401-285-1401
  • Fax:
Mailing address:
  • Phone: 410-285-1401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21506
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: