| Doctor Name: | DR. TAGBO JOHN EKWONU |
| NPI Number: | 1093890535 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 9900826 |
| Business Practice Address: | 4115 The Plz Eastowne Family Physicians, P.a, Charlotte, NC - 282051356 |
| Business Phone Number: | 7045324567 |
| Business Fax Number: | 7045324580 |
| Mailing Address: | Po Box 1280, MATTHEWS |
| State: | NC |
| Postal Code: | 281061280 |
| Phone Number: | 7045324567 |
| Fax Number: | 7045324580 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 08/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | 9900826 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |