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Organization

NORTHSTAR INTERNAL MEDICINE PA

Active
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Organization

NORTHSTAR INTERNAL MEDICINE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IKECHUKWU A NWABUDE MD (PRESIDENT AND CEO)
(469) 209-9110
Entity
Organization

Contact information

Practice address
5720 APPALOSSA DR, GRAND PRAIRIE, TX 75052-2522
(817) 717-1299
Mailing address
5720 APPALOSSA DR, GRAND PRAIRIE, TX 75052-2522
(469) 209-9110

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N5288
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
N5288
TEXAS LICENSE
TX
Enumeration date
10/17/2012
Last updated
04/17/2024
About Stedi
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  • EDI platform