Healthcare Provider Details

I. General information

NPI: 1033566849
Provider Name (Legal Business Name): REMI TOKUNBO OKWECHIME MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADEREMI ADETOKUNBO FATUYI M.D., M.P.H.

II. Dates (important events)

Enumeration Date: 05/21/2016
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 JOHNSTON WILLIS DR
NORTH CHESTERFIELD VA
23235-4730
US

IV. Provider business mailing address

ELMWOOD AVE BOX 278984
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 804-483-5000
  • Fax:
Mailing address:
  • Phone: 585-275-1200
  • Fax: 585-756-5189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number311801
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101282601
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number313222
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: