Individual
DR. OKECHUKWU C IFEDIORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1908 ROYAL AVE, MONROE, LA 71201-5724
(318) 325-5435
(318) 325-8852
Mailing address
PO BOX 14474, MONROE, LA 71207-4474
(318) 325-5435
(318) 325-8852
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
09448R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1937983
—
LA
01
—
H25001
VANTAGE
—
Enumeration date
10/06/2005
Last updated
03/26/2009
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