Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | D56462 | MD |
Y | 207R00000X | Internist | D56462 | MD |
Y | 111NI0900X | Internist | D56462 | MD |
N | 207RI0200X | Infectious Disease | D56462 | MD |
NPI | 1073552881 |
---|---|
Provider Name | Dr. Michael C Obiefune |
First Address | Baltimore, MD 21201-1544 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 14/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I06917 | (02) |