Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01075029A | IN |
Y | 207VX0201X | Gynecologic Oncologist | 01075029A | IN |
NPI | 1124262522 |
---|---|
Provider Name | Nonyem Onujiogu |
First Address | South Bend, IN 46617-1924 |
Second Address | South Bend, IN 46601-1168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2009 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201283350 | (05) | IN |
261930007 | MEDICARE PTAN (01) | IN |