Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036124320 | IL |
N | 208000000X | Pediatrician | 2014-01745 | NC |
N | 208000000X | Pediatrician | MD2010-0174 | NM |
Y | 208000000X | Pediatrician | Q2478 | TX |
NPI | 1003072695 |
---|---|
Provider Name | Ruth Osei Fordjour |
First Address | Dallas, TX 75251-2202 |
Second Address | Dallas, TX 75251-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2008 |
Last Update Date | 19/07/2015 |