Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301092567 | MI |
Y | 111NI0900X | Internist | 4301092567 | MI |
N | 208000000X | Pediatrician | 4301092567 | MI |
NPI | 1003069766 |
---|---|
Provider Name | Dr. Ijeoma Nnodim Opara |
First Address | Detroit, MI 48201-2136 |
Second Address | Detroit, MI 48201-1804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 22/07/2020 |