Provider Demographics
NPI:1447143417
Name:EZUOKE, AUGUSTINE IKECHUKWU
Entity type:Individual
Prefix:
First Name:AUGUSTINE
Middle Name:IKECHUKWU
Last Name:EZUOKE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 WHITFIELD CHAPEL RD APT 201
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2560
Mailing Address - Country:US
Mailing Address - Phone:240-616-8092
Mailing Address - Fax:240-616-8092
Practice Address - Street 1:5644 WHITFIELD CHAPEL RD APT 201
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2560
Practice Address - Country:US
Practice Address - Phone:240-616-8092
Practice Address - Fax:240-616-8092
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator