MEDICARE: GODSWILL O. OKOJI, M.D., LLC

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	207R00000X	Internal Medicine Physician	D00550545	MD
2	207R00000X	Internal Medicine Physician	MD30509	DC

General Provider Information

NPI Number	:	1770886319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GODSWILL O. OKOJI, M.D., LLC

Provider Business Mailing Address
First Line	:	7517 NEW HAMPSHIRE AVE
Second Line	:	1809 BENNING ROAD N.E.
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-6969
Country	:	US
Telephone Number	:	301-408-4111
Fax Number	:	301-408-4600

Provider Business Practice Location Address
First Line	:	7517 NEW HAMPSHIRE AVENUE
Second Line	:	1809 BENNING ROAD N.E.
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-6969
Country	:	US
Telephone Number	:	301-408-4111
Fax Number	:	301-408-4600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GODSWILL O OKOJI
Credential	:	M.D.
Telephone Number	:	301-408-4111

Provider Enumeration Date	:	12/20/2010
Last Update Date	:	12/20/2010

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