Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R1428 | KY |
N | 111NI0900X | Internist | R1428 | KY |
Y | 207RI0200X | Infectious Disease | OH 35093594 | OH |
NPI | 1073630893 |
---|---|
Provider Name | Dr. Uchenna A Ezike |
First Address | Mansfield, OH 44901-5096 |
Second Address | Mansfield, OH 44907-1057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2007 |
Last Update Date | 29/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2595286 | (05) | OH |