Healthcare Provider Details

I. General information

NPI: 1568357853
Provider Name (Legal Business Name): DR. ESELEBOR OKOJIE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7848 WISE AVE
DUNDALK MD
21222-3338
US

IV. Provider business mailing address

5920 GREAT STAR DR UNIT 206
CLARKSVILLE MD
21029-1359
US

V. Phone/Fax

Practice location:
  • Phone: 410-282-0218
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29666
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: