Provider Demographics
NPI:1346635679
Name:OKOEV, GRIGORI (MD)
Entity Type:Individual
Prefix:DR
First Name:GRIGORI
Middle Name:
Last Name:OKOEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10751 ENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1417
Mailing Address - Country:US
Mailing Address - Phone:240-715-7620
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD STE 294
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5049
Practice Address - Country:US
Practice Address - Phone:717-741-9229
Practice Address - Fax:717-741-9605
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0091105207R00000X, 207RH0003X
PAMD479403207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine