Provider Demographics
NPI:1447604376
Name:EASTWAY MEDICAL CLINIC & URGENT CARE, PLLC
Entity type:Organization
Organization Name:EASTWAY MEDICAL CLINIC & URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:IFEYINWA
Authorized Official - Last Name:OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-360-8893
Mailing Address - Street 1:1220 EASTWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2202
Mailing Address - Country:US
Mailing Address - Phone:704-360-8893
Mailing Address - Fax:704-626-6515
Practice Address - Street 1:1220 EASTWAY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-2202
Practice Address - Country:US
Practice Address - Phone:704-360-8893
Practice Address - Fax:704-626-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty