Provider Demographics
NPI:1174083711
Name:OKOYE, OKECHUKWU C
Entity type:Individual
Prefix:
First Name:OKECHUKWU
Middle Name:C
Last Name:OKOYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740
Mailing Address - Country:US
Mailing Address - Phone:301-791-6680
Mailing Address - Fax:301-714-1506
Practice Address - Street 1:346 MILL STREET
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:301-791-6680
Practice Address - Fax:301-714-1506
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD30756400Medicaid