Provider Demographics
NPI:1225414600
Name:IHEKIRE, CHUKWUDI KEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUDI
Middle Name:KEL
Last Name:IHEKIRE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KEL
Other - Middle Name:CHUKWUDI
Other - Last Name:IHEKIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9701 BRANCHLEIGH RD APT 2
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2153
Mailing Address - Country:US
Mailing Address - Phone:513-967-6497
Mailing Address - Fax:
Practice Address - Street 1:9701 BRANCHLEIGH RD APT 2
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2153
Practice Address - Country:US
Practice Address - Phone:513-967-6497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist