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General NPI Number Information
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NPI Number | 1639342363
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Entity Type | Individual
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Provider Name | KENNETH CHIEDU OBIAJA M.D. , M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 5089 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-1326
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Country | US
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Telephone | 352-753-0606
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Fax | 352-365-1003
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Provider Business Mailing Address
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Address Line | 2995 DREW ST
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City | CLEARWATER
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State | FL
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Zip | 33759-3012
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Country | US
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Telephone | 727-315-7496
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD448717
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME108204
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License Number State | FL
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