Organization
FORT MORGAN PEDIATRIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEHINDE OBETO MD (PRESIDENT)
(213) 926-3249
Entity
Organization
Contact information
Practice address
3564 DEER CREEK DR, MAUMEE, OH 43537-8979
(530) 355-3775
Mailing address
3564 DEER CREEK DR, MAUMEE, OH 43537-8979
(530) 355-3775
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46228
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46228
STATE LICENSE
CO
Enumeration date
01/16/2008
Last updated
10/14/2020
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