Provider Demographics
NPI:1861109944
Name:EKE, CHIDIOGO (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHIDIOGO
Middle Name:
Last Name:EKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14402 STEPPING STONE WAY
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1937
Mailing Address - Country:US
Mailing Address - Phone:732-485-8073
Mailing Address - Fax:
Practice Address - Street 1:4101 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2616
Practice Address - Country:US
Practice Address - Phone:732-485-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist