MEDICARE: CHINYERE OKEKE MD LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	14416	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1255562880	OTHER	NV	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1477980894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHINYERE OKEKE MD LTD

Provider Business Mailing Address
First Line	:	PO BOX 400997
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-0997
Country	:	US
Telephone Number	:	702-202-0099
Fax Number	:	702-778-7632

Provider Business Practice Location Address
First Line	:	2001 S RAINBOW BLVD
Second Line	:	SUITE 130
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2990
Country	:	US
Telephone Number	:	702-202-0099
Fax Number	:	702-778-7632

Authorized Official
Title or Position	:	PRESIDENT/ PHYSICIAN
Name	:	DR. CHINYERE L OKEKE
Credential	:	MD
Telephone Number	:	702-202-0099

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	09/30/2013

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Directions to “CHINYERE OKEKE MD LTD ” Practice Location

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