Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 128304 | NC |
Y | 207VX0201X | Gynecologic Oncologist | 01076188A | IN |
N | 207VX0201X | Gynecologic Oncologist | 104397 | MN |
N | 207VX0201X | Gynecologic Oncologist | 52152 | MN |
N | 207VX0201X | Gynecologic Oncologist | P4545 | TX |
NPI | 1306006218 |
---|---|
Provider Name | Dr. Tina A Ayeni |
First Address | Greenwood, IN 46143-7241 |
Second Address | Indianapolis, IN 46237-8601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 17/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
308690201 (MDACC) | (05) | TX |