Healthcare Provider Details

I. General information

NPI: 1265827331
Provider Name (Legal Business Name): OBEHIOYE OKOJIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2015
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NEW ULM MEDICAL CENTER 1217 8TH ST N
NEW ULM MN
56073-1552
US

IV. Provider business mailing address

215 W PERSHING RD UNIT 904
KANSAS CITY MO
64108-4322
US

V. Phone/Fax

Practice location:
  • Phone: 507-217-5000
  • Fax:
Mailing address:
  • Phone: 301-213-9791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberB203341012
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: