Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 019.030759 | IL |
N | 1223D0001X | Dental Public Health | 019.030759 | IL |
Y | 1223G0001X | General Practice | 019.030759 | IL |
Y | 213EG0000X | General Practice | 019.030759 | IL |
NPI | 1356792097 |
---|---|
Provider Name | Dr. Uvoh Erhiegueke Onoriobe |
First Address | Plymouth, MI 48170-3923 |
Second Address | Plymouth, MI 48170-3923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2016 |
Last Update Date | 23/06/2016 |