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General NPI Number Information
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NPI Number | 1780027938
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Entity Type | Individual
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Provider Name | ESEOGHENE ABOKEDE M.D
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Gender | Female
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 1601 SAINT FRANCIS AVE STE 100
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City | SHAKOPEE
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State | MN
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Zip | 55379-3384
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Country | US
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Telephone | 952-428-3535
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Fax | 952-428-3599
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Provider Business Mailing Address
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Address Line | 2854 HIGHWAY 55 STE 190
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City | EAGAN
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State | MN
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Zip | 55121-1783
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Country | US
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Telephone | 612-345-9900
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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 | 59851
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License Number State | MN
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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 | 64805
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License Number State | WI
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