Provider Demographics
NPI:1053647354
Name:EZEOCHA, ADINDU DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADINDU
Middle Name:DAVID
Last Name:EZEOCHA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5804 RITCHIE HWY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21225
Mailing Address - Country:US
Mailing Address - Phone:410-789-3775
Mailing Address - Fax:410-789-5812
Practice Address - Street 1:5804 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225
Practice Address - Country:US
Practice Address - Phone:410-789-3775
Practice Address - Fax:410-789-5812
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist