Provider Demographics
NPI:1518980812
Name:OKOJI, GODSWILL O (MD)
Entity Type:Individual
Prefix:DR
First Name:GODSWILL
Middle Name:O
Last Name:OKOJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3331 TOLEDO TER STE 108
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-8156
Mailing Address - Country:US
Mailing Address - Phone:301-408-4111
Mailing Address - Fax:301-408-4600
Practice Address - Street 1:3331 TOLEDO TER STE 108
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-8156
Practice Address - Country:US
Practice Address - Phone:301-408-4111
Practice Address - Fax:301-408-4600
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD00B176U80OtherMEDICARE RENDERING
MD206400601Medicaid
DC017125200Medicaid
G42951Medicare UPIN