Provider Demographics
NPI:1356086755
Name:EKEZIE, NWANDO (MD)
Entity type:Individual
Prefix:
First Name:NWANDO
Middle Name:
Last Name:EKEZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 DAVIDSON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-3324
Mailing Address - Country:US
Mailing Address - Phone:347-819-6129
Mailing Address - Fax:
Practice Address - Street 1:1920 L ST NW STE 350
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5072
Practice Address - Country:US
Practice Address - Phone:202-296-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101286342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine