Provider Demographics
NPI:1770898363
Name:OKOCHA, IFEYINWA (MD)
Entity type:Individual
Prefix:DR
First Name:IFEYINWA
Middle Name:
Last Name:OKOCHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FY-FY
Other - Middle Name:
Other - Last Name:OKOCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7525 GREENWAY CENTER DR
Mailing Address - Street 2:245
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3509
Mailing Address - Country:US
Mailing Address - Phone:301-474-8118
Mailing Address - Fax:301-345-1271
Practice Address - Street 1:7525 GREENWAY CENTER DR
Practice Address - Street 2:245
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3509
Practice Address - Country:US
Practice Address - Phone:301-474-8118
Practice Address - Fax:301-345-1271
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038794207K00000X, 208000000X
MDD0071021207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics