Healthcare Provider Details

I. General information

NPI: 1558904193
Provider Name (Legal Business Name): CHRISTOPHER OKOYE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2019
Last Update Date: 10/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 HAWTHORN DR
HANOVER MD
21076-2200
US

IV. Provider business mailing address

1407 HAWTHORN DR
HANOVER MD
21076-2200
US

V. Phone/Fax

Practice location:
  • Phone: 443-542-8985
  • Fax:
Mailing address:
  • Phone: 443-542-8985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24288
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: