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Individual
EDEM NYONATOR
Active
Individual
EDEM NYONATOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD26162
OR
208M00000X
Hospitalist Physician
Primary
MD26162
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026826
—
OR
01
—
838334011
BCBS-ROSEBURG
OR
01
—
858463010
BCBS-MEDFORD
OR
01
—
858464008
BCBS-SPRINGFIELD
OR
01
—
P00276736
RR MEDICARE
OR
Enumeration date
03/28/2006
Last updated
03/17/2018
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