Provider Demographics
NPI:1316632656
Name:ESEZOBOR, CHRISTOPHER IMOKHUEDE (MBBS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:IMOKHUEDE
Last Name:ESEZOBOR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 CHILDRENS LN
Mailing Address - Street 2:EASTERN VIRGINIA MEDICAL SCHOOL PROGRAM
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1910
Mailing Address - Country:US
Mailing Address - Phone:757-668-9994
Mailing Address - Fax:
Practice Address - Street 1:601 CHILDRENS LN
Practice Address - Street 2:EASTERN VIRGINIA MEDICAL SCHOOLPROGRAM
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1910
Practice Address - Country:US
Practice Address - Phone:757-668-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2024-05-30
Deactivation Date:2023-10-11
Deactivation Code:
Reactivation Date:2024-05-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program