Basic Information
Provider Information
NPI: 1720215155
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ENUJIOKE
FirstName: SHARON
MiddleName: CHINYERE
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 620 JOHN PAUL JONES CIR
Address2:  
City: PORTSMOUTH
State: VA
PostalCode: 237082111
CountryCode: US
TelephoneNumber: 7579535000
FaxNumber:  
Practice Location
Address1: 620 JOHN PAUL JONES CIR
Address2:  
City: PORTSMOUTH
State: VA
PostalCode: 237082111
CountryCode: US
TelephoneNumber: 7579535000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2009
LastUpdateDate: 04/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080A0000X01068685AINN Allopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2080A0000X0101272443VAY Allopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine

No ID Information.


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