Provider Demographics
NPI:1457915431
Name:OBIOHA, OBIANUJU ADAMMA (MD)
Entity type:Individual
Prefix:DR
First Name:OBIANUJU
Middle Name:ADAMMA
Last Name:OBIOHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 CAREW ST STE 160
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2391
Mailing Address - Country:US
Mailing Address - Phone:413-748-7350
Mailing Address - Fax:
Practice Address - Street 1:175 CAREW ST STE 160
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2391
Practice Address - Country:US
Practice Address - Phone:413-748-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81410207XX0005X
MA1024492207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty