Provider Demographics
NPI:1447315536
Name:EREKOSIMA, NKIRUKA UGOCHI (MD, MPH)
Entity type:Individual
Prefix:
First Name:NKIRUKA
Middle Name:UGOCHI
Last Name:EREKOSIMA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:NKIRUKA
Other - Middle Name:UGOCHI
Other - Last Name:OHAMEJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:2415 MUSGROVE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5202
Mailing Address - Country:US
Mailing Address - Phone:301-879-7700
Mailing Address - Fax:
Practice Address - Street 1:2415 MUSGROVE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5202
Practice Address - Country:US
Practice Address - Phone:301-879-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD69011207RA0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510519600Medicaid
MD510519600Medicaid