Provider Demographics
NPI:1316934953
Name:EZIKE, NGOZI (MD)
Entity type:Individual
Prefix:
First Name:NGOZI
Middle Name:
Last Name:EZIKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NGOZI
Other - Middle Name:
Other - Last Name:EJIOGU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3501 SINCLAIR LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2029
Mailing Address - Country:US
Mailing Address - Phone:410-558-4888
Mailing Address - Fax:410-327-1693
Practice Address - Street 1:251 BAYVIEW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2816
Practice Address - Country:US
Practice Address - Phone:410-558-8627
Practice Address - Fax:410-558-8067
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD58730207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine