Provider Demographics
NPI:1285272070
Name:ESOKAWU, JUSTHEO
Entity type:Individual
Prefix:
First Name:JUSTHEO
Middle Name:
Last Name:ESOKAWU
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 1:4172 DALCROSS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6440
Mailing Address - Country:US
Mailing Address - Phone:919-888-8115
Mailing Address - Fax:
Practice Address - Street 1:4172 DALCROSS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-6440
Practice Address - Country:US
Practice Address - Phone:919-888-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide