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General NPI Number Information
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NPI Number | 1588351597
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Entity Type | Individual
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Provider Name | EVANS OBINNA OKONKWO MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 8901 ROCKVILLE PIKE
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City | BETHESDA
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State | MD
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Zip | 20889-5095
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101283168
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License Number State | VA
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