Individual
DR. EBENEZER A NII-MOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 E MARSHALL AVE STE 3000, LONGVIEW, TX 75601-5661
(906) 758-2610
(903) 758-7081
Mailing address
1107 E MARSHALL AVE, LONGVIEW, TX 75601-5602
(903) 758-2610
(903) 212-7689
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD431796
PA
207V00000X
Obstetrics & Gynecology Physician
Primary
Q8114
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3651184-01
—
TX
01
—
8GK198
BCBS TX
TX
Enumeration date
09/12/2007
Last updated
04/26/2024
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