Provider Demographics
NPI:1912266842
Name:EKWUTIFE, JOSEPH OKEZIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:OKEZIE
Last Name:EKWUTIFE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 HIGHCREST CT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1413
Mailing Address - Country:US
Mailing Address - Phone:410-960-9873
Mailing Address - Fax:
Practice Address - Street 1:22 CARROLL PLZ
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-4601
Practice Address - Country:US
Practice Address - Phone:410-876-1513
Practice Address - Fax:410-857-5072
Is Sole Proprietor?:No
Enumeration Date:2012-05-13
Last Update Date:2012-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17808183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist