Provider Demographics
NPI:1134331457
Name:OKEKE, MICHAEL IFEANYI (MT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:IFEANYI
Last Name:OKEKE
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 EUCLID RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5805
Mailing Address - Country:US
Mailing Address - Phone:757-337-7740
Mailing Address - Fax:
Practice Address - Street 1:4901 EUCLID RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5805
Practice Address - Country:US
Practice Address - Phone:757-337-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist