Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.128392 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35.128392 | OH |
NPI | 1013354968 |
---|---|
Provider Name | Dr. Jacqueline Dela Doamekpor |
First Address | Cleveland, OH 44111-5612 |
Second Address | Cleveland, OH 44111-5612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2013 |
Last Update Date | 09/04/2019 |