Provider Demographics
NPI:1689747859
Name:OKONKWO, MARGARET IFEANYICHUKWU (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:IFEANYICHUKWU
Last Name:OKONKWO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2731 ML KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-5235
Mailing Address - Country:US
Mailing Address - Phone:205-349-3250
Mailing Address - Fax:205-752-1517
Practice Address - Street 1:4112 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3504
Practice Address - Country:US
Practice Address - Phone:305-576-5437
Practice Address - Fax:305-576-5120
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME82932208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL179325OtherJMH
FLSG07583977OtherVISTA HEALTH PLAN
FL2149727OtherFIRST HEALTH
FL269034900Medicaid
FL50311058OtherPREFERRED MEDICAL PLAN
FL198025OtherAMERIGROUP
FL37607OtherBLUE CROSS BLUE SHIELD
FL48360OtherNEIGHBORHOOD HEALTH PARTE
FL7208679OtherAETNA
FL293667OtherAVMED
FL1492927OtherCIGNA
FL29321OtherPMP HMO
FLP3221934OtherMULTIPLAN