Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 19937 | MS |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD.203716 | LA |
NPI | 1043267818 |
---|---|
Provider Name | Gabriel Ikponmosa Uwaifo |
First Address | New Orleans, LA 70121-2429 |
Second Address | Slidell, LA 70461-4149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 30/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034604200 | (05) | DC |
05538368 | (05) | MS |
106178 | (05) | AL |
106178 | (05) | MS |
1393959 | (05) | LA |
401048500 | (05) | MD |
58884349 | (05) | VA |
H80293 | (02) | DC |
P00001410 | (02) | DC |