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General NPI Number Information
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NPI Number | 1285122861
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Entity Type | Individual
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Provider Name | ONYEDIKA VICTOR UMEANAETO MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2018
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 503 MCMILLAN RD
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City | WEST MONROE
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State | LA
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Zip | 71291-5327
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Country | US
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Telephone | 318-329-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 GRAYCLIFF DR APT 217
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City | DALLAS
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State | TX
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Zip | 75228-7222
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Country | US
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Telephone | 929-204-3933
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 56515
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | U2028
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 328317
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License Number State | LA
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