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Individual

TAJUDEEN OGBARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2075 INDIANAPOLIS BLVD, WHITING, IN 46394-1948
(219) 659-7000
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
(219) 836-0034

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
01040726A
IN
207RI0200X
Infectious Disease Physician
Primary
036085105
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200082460
IN
01
440002427
RR MEDICARE PTAN
IN
Enumeration date
12/28/2005
Last updated
09/23/2014
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