Healthcare Provider Details

I. General information

NPI: 1285883884
Provider Name (Legal Business Name): SYLVIA IFEYINWA OKOYE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 EASTWAY DR
CHARLOTTE NC
28205-2202
US

IV. Provider business mailing address

1220 EASTWAY DR
CHARLOTTE NC
28205-2202
US

V. Phone/Fax

Practice location:
  • Phone: 704-360-8893
  • Fax: 704-626-6515
Mailing address:
  • Phone: 704-360-8893
  • Fax: 704-626-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number002503
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2010-01533
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: