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NPI Code Detail

MEDICARE: DR.BONAVENTURE C. OKORO MD, INC.

MEDICARE: DR.BONAVENTURE C. OKORO MD, INC.
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
1207R00000XInternal Medicine PhysicianB05196541OH

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 : 1073847091
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR.BONAVENTURE C. OKORO MD, INC.
Provider Business Mailing Address
First Line : 5542 AIRPORT HWY
Second Line :
City : TOLEDO
State : OH
Zip : 43615-7304
Country : US
Telephone Number : 419-865-6522
Fax Number : 419-865-6523
Provider Business Practice Location Address
First Line : 5542 AIRPORT HIGHWAY
Second Line :
City : TOLEDO
State : OH
Zip : 43615-7304
Country : US
Telephone Number : 419-865-6522
Fax Number : 419-865-6523
Authorized Official
Title or Position : PRESIDENT
Name : BONAVENTURE C OKORO
Credential : MD
Telephone Number : 419-865-6522
Provider Enumeration Date : 09/23/2009
Last Update Date : 11/21/2013

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