Provider Demographics
NPI:1013995216
Name:IMOKE, EFEM E (MD)
Entity Type:Individual
Prefix:DR
First Name:EFEM
Middle Name:E
Last Name:IMOKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9601 PULASKI PARK DR
Mailing Address - Street 2:SUITE 416
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1409
Mailing Address - Country:US
Mailing Address - Phone:410-933-5678
Mailing Address - Fax:410-238-7451
Practice Address - Street 1:9601 PULASKI PARK DR
Practice Address - Street 2:SUITE 416
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-1409
Practice Address - Country:US
Practice Address - Phone:410-933-5678
Practice Address - Fax:410-238-7451
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2016-01-03
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Provider Licenses
StateLicense IDTaxonomies
MS22450208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05251568Medicaid
MS278330YQVYMedicare PIN