Provider Demographics
NPI:1790099067
Name:MUNONYE, EMEKA KENNETH (RPH)
Entity Type:Individual
Prefix:
First Name:EMEKA
Middle Name:KENNETH
Last Name:MUNONYE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MORAN CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-6452
Mailing Address - Country:US
Mailing Address - Phone:310-489-9982
Mailing Address - Fax:
Practice Address - Street 1:22411 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-2063
Practice Address - Country:US
Practice Address - Phone:301-824-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist