Individual
PETERS EHIOSUOREA OKONOBOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-0001
(413) 794-4320
Mailing address
280 CHESTNUT STREET, 2ND FLOOR, SPRINGFIELD, MA 01107-2658
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261781
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
261781
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215166020
—
VA
05
—
5920972
—
NC
Enumeration date
07/14/2009
Last updated
09/19/2017
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