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General NPI Number Information
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NPI Number | 1982460523
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Entity Type | Individual
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Provider Name | MR. OGOCHUKWU N EZUMBA
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Gender | Male
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 5715 W APPLETON AVE
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City | MILWAUKEE
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State | WI
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Zip | 53210-2250
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Country | US
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Telephone | 414-988-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 2326 E MENLO BLVD
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City | SHOREWOOD
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State | WI
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Zip | 53211-2608
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Country | US
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Telephone | 141-470-8391
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302048478
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21263-40
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License Number State | WI
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