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NPI Code Detail

MEDICARE: TAJUDEEN OGBARA M.D.

MEDICARE:   TAJUDEEN  OGBARA  M.D.
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
1440002427OTHERINRR MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124005418
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAJUDEEN OGBARA M.D.
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 : 219-836-0034
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 09/23/2014

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Directions to “ TAJUDEEN OGBARA M.D.” Practice Location

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