Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 01064140 | IN |
Y | 207RP1001X | Pulmonary Disease | 01064140 | IN |
N | 207RS0012X | Sleep Medicine | 01604140 | IN |
NPI | 1043298961 |
---|---|
Provider Name | Dr. Olusegun Apata |
First Address | Merrillville, IN 46411-0068 |
Second Address | Gary, IN 46404-1551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 31/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200876640 | (05) | IN |
F94947 | (02) | WI |