Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 350825510 | OH |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 35.082551 | OH |
NPI | 1144286634 |
---|---|
Provider Name | Dr. Mausi A Okunade |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2486546 | (05) | OH |
64082324 | (05) | KY |
I13602 | (02) |