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NPI Code Detail

MEDICARE: TAJUDEEN OGBARA, M.D., S.C.

MEDICARE: TAJUDEEN OGBARA, M.D., S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease Physician01040726AIN
2207RI0200XInfectious Disease Physician036085105IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DB9982OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053375014
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAJUDEEN OGBARA, M.D., S.C.
Provider Business Mailing Address
First Line : 9201 CALUMET AVE
Second Line :
City : MUNSTER
State : IN
Zip : 46321-2807
Country : US
Telephone Number : 219-836-2022
Fax Number :
Provider Business Practice Location Address
First Line : 2075 INDIANAPOLIS BLVD
Second Line :
City : WHITING
State : IN
Zip : 46394-1948
Country : US
Telephone Number : 219-659-7000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : TAJUDEEN OGBARA
Credential : M.D.
Telephone Number : 219-836-2022
Provider Enumeration Date : 04/14/2006
Last Update Date : 09/23/2014

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