Provider Demographics
NPI:1053161273
Name:EZEPUE, EBERECHUKWU JOAN (MD)
Entity type:Individual
Prefix:
First Name:EBERECHUKWU
Middle Name:JOAN
Last Name:EZEPUE
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:COOPER UNIVERSITY HEALTH CARE
Mailing Address - Street 2:1 COOPER PLAZA
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COOPER UNIVERSITY HEALTH CARE
Practice Address - Street 2:1 COOPER PLAZA
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program