Provider Demographics
NPI:1841574332
Name:OHWOFAHWORAYE, ENOVWO ELOHO (PHARMD, DO)
Entity Type:Individual
Prefix:DR
First Name:ENOVWO
Middle Name:ELOHO
Last Name:OHWOFAHWORAYE
Suffix:
Gender:M
Credentials:PHARMD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3372
Mailing Address - Country:US
Mailing Address - Phone:740-687-6951
Mailing Address - Fax:
Practice Address - Street 1:401 N EWING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3372
Practice Address - Country:US
Practice Address - Phone:740-687-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03226174183500000X
OHAP2282058A49207R00000X
OH34.013090207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No183500000XPharmacy Service ProvidersPharmacist