MEDICARE: MATTHEW OBI OKEKE MD

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	2084P0800X	Psychiatry Physician	CS10935	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

General Provider Information

NPI Number	:	1730272709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW OBI OKEKE MD

Provider Business Mailing Address
First Line	:	2021 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3137
Country	:	US
Telephone Number	:	702-202-0099
Fax Number	:	702-778-7632

Provider Business Practice Location Address
First Line	:	2021 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3137
Country	:	US
Telephone Number	:	702-202-0099
Fax Number	:	702-778-7632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	04/09/2015

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