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1780781781

NPI Code Detail

MEDICARE: DR. OBUKOHWO FRANCIS SIDO MD

MEDICARE: DR. OBUKOHWO FRANCIS SIDO MD

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
1	207R00000X	Internal Medicine Physician	87317	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	9709	OTHER	NC	PARTNERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34D0977558	OTHER	NC	CLIA
2	76667	OTHER	NC	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780781781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OBUKOHWO FRANCIS SIDO MD

Provider Business Mailing Address
First Line	:	1343 E GARRISON BLVD
Second Line	:	STE A
City	:	GASTONIA
State	:	NC
Zip	:	28054-5137
Country	:	US
Telephone Number	:	704-861-9117
Fax Number	:

Provider Business Practice Location Address
First Line	:	1343 E GARRISON BLVD
Second Line	:	STE A
City	:	GASTONIA
State	:	NC
Zip	:	28054-5137
Country	:	US
Telephone Number	:	704-861-9117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/11/2011

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Directions to “ DR. OBUKOHWO FRANCIS SIDO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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