Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME133150 | FL |
NPI | 1356636591 |
---|---|
Provider Name | Obinna Ogechukwu Adigweme |
First Address | Orlando, FL 32806-4476 |
Second Address | Winter Park, FL 32789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 04/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021773300 | (05) | FL |