Provider Demographics
NPI:1942663364
Name:OKEKE, CHINEDU OBINNA (MD)
Entity Type:Individual
Prefix:
First Name:CHINEDU
Middle Name:OBINNA
Last Name:OKEKE
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 1:331 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-8632
Mailing Address - Country:US
Mailing Address - Phone:954-440-0983
Mailing Address - Fax:
Practice Address - Street 1:331 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-8632
Practice Address - Country:US
Practice Address - Phone:954-440-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL60001614207ZP0102X
VA0101271636208D00000X
FLME148534208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology