Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 01054003A | IN |
NPI | 1295712685 |
---|---|
Provider Name | Dr. Ekanem A Akinola |
First Address | Muncie, IN 47302-5756 |
Second Address | Muncie, IN 47302-2333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H90672 | (02) | IN |