Provider Demographics
NPI:1104343466
Name:OKOJIE, HENRY
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:OKOJIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1310
Mailing Address - Country:US
Mailing Address - Phone:301-772-1100
Mailing Address - Fax:301-747-1604
Practice Address - Street 1:6421 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1310
Practice Address - Country:US
Practice Address - Phone:301-772-1100
Practice Address - Fax:301-747-1604
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDO220303000696172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver