Provider Demographics
NPI:1053809186
Name:EZEKWE, EJIOFOR ANTHONY DARRELL JR
Entity type:Individual
Prefix:DR
First Name:EJIOFOR
Middle Name:ANTHONY DARRELL
Last Name:EZEKWE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8348 SILVER TRUMPET DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5635
Mailing Address - Country:US
Mailing Address - Phone:410-790-4884
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-4220
Practice Address - Country:US
Practice Address - Phone:240-539-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01026162080P0201X
DCMD0492722080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology