Provider Demographics
NPI:1306420096
Name:OKEREKE, VICTORIA U
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:U
Last Name:OKEREKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 GREENBELT RD STE 207
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6227
Mailing Address - Country:US
Mailing Address - Phone:301-552-8755
Mailing Address - Fax:301-552-8770
Practice Address - Street 1:9801 GREENBELT RD STE 207
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6227
Practice Address - Country:US
Practice Address - Phone:301-552-8755
Practice Address - Fax:301-552-8770
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145361835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty