Individual
NDIDI O ENWEREJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 TOWER DR STE 420, TROY, MI 48098-2827
(800) 367-5690
Mailing address
7430 2ND AVE APT 729, DETROIT, MI 48202-2756
(240) 175-5389
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
4301512551
MI
208D00000X
General Practice Physician
Primary
5315240684
MI
Other
Enumeration date
03/23/2023
Last updated
07/31/2024
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