Osita Victor Ezeakudo
Pediatrician
2510 E Dupont Rd Suite 200
Fort Wayne
, Indiana 46825-1601
Osita Victor Ezeakudo
Pediatrician
2510 E Dupont Rd Suite 200
Fort Wayne
, Indiana 46825-1601
(260) 969-6833
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Osita Victor Ezeakudo
- 2518 E Dupont Rd
- Fort Wayne, IN
- Zip : 46825-1675
- Fax : (260) 969-6833
- Phone : (260) 432-4400
Second Address
- Osita Victor Ezeakudo
- 2510 E Dupont Rd Suite 200
- Fort Wayne, IN
- Zip : 46825-1601
- Fax : (260) 969-6832
- Phone : (260) 432-4913
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 01065437A | IN |
National Provider Identifier
| NPI | 1013078351 |
|---|---|
| Provider Name | Osita Victor Ezeakudo |
| First Address | Fort Wayne, IN 46825-1675 |
| Second Address | Fort Wayne, IN 46825-1601 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/12/2006 |
| Last Update Date | 31/01/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200910310 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.