Ikechi Konkwo

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

C1-0012159 Issued in DE

Practice address

1275 S State St
Dover, DE 19901-6927

Phone

(302) 672-2319

Fax

(302) 672-2341

NPI assigned

Apr 18, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508286485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016927",
            "telephone_number": "302-672-2319",
            "fax_number": "302-672-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016927",
            "telephone_number": "302-672-2319",
            "fax_number": "302-672-2341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-3903",
            "fax_number": "904-244-3020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONKWO",
        "first_name": "IKECHI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "DE",
            "license": "C1-0012159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph K Koehler
• Terri E Koehler, CRNA
• Thomas A Kolakowski Jr., RPH
• Volha Stepanovna Komar, PA-C
• Victoria E Kong, MD
• Atang Koodirile, MD
• Krista Lea Marita Koskinen, M.D.
• Catherine J Kotalik, PA
• Abigail Kozhuharov
• Lillian Virginia Kraman-Roach, MD

• Preventive Medicine/Occupational Environmental Medicine Physician in Dover, DE
• Providers in Dover, DE by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.