Healthcare Provider Details

I. General information

NPI: 1144650979
Provider Name (Legal Business Name): DR. ALBERT OKYERE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 KATRINA CT
TRIANGLE VA
22172-2062
US

IV. Provider business mailing address

3511 KATRINA CT
TRIANGLE VA
22172-2062
US

V. Phone/Fax

Practice location:
  • Phone: 703-399-0686
  • Fax:
Mailing address:
  • Phone: 703-399-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18502
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: