Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 22450 | MS |
Y | 208600000X | Surgeon | 22450 | MS |
NPI | 1013995216 |
---|---|
Provider Name | Dr. Efem E Imoke |
First Address | Baltimore, MD 21220-1409 |
Second Address | Baltimore, MD 21220-1409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 03/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05251568 | (05) | MS |