Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125 | IL |
N | 111NI0900X | Internist | 125 | IL |
N | 207R00000X | Internist | MD447986 | PA |
N | 111NI0900X | Internist | MD447986 | PA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 62720 | MN |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301104529 | MI |
NPI | 1063737831 |
---|---|
Provider Name | Chike Uchenna Anthony Obi |
First Address | Detroit, MI 48202-2608 |
Second Address | Robbinsdale, MN 55422-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 31/12/2018 |