Provider Demographics
NPI:1144070871
Name:OGBONNA, OBINNA EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:OBINNA
Middle Name:EMMANUEL
Last Name:OGBONNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-3708
Mailing Address - Country:US
Mailing Address - Phone:267-266-7261
Mailing Address - Fax:
Practice Address - Street 1:458 PHEASANT LN
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-3708
Practice Address - Country:US
Practice Address - Phone:267-266-7261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program