Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 04-24593 | KS |
Y | 208000000X | Pediatrician | 04-24593 | KS |
N | 2080P0205X | Pediatric Endocrinologist | 04-24593 | KS |
NPI | 1336249200 |
---|---|
Provider Name | Vanaja R Obi |
First Address | Salina, KS 67401-4189 |
Second Address | Salina, KS 67401-4189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 20/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100147460BC | (05) | KS |
E62128 | (02) |