Individual
IDARA JOHN EDEM
Active
Individual
IDARA JOHN EDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MSC, FRCPC
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301502929
MI
Other
Enumeration date
08/22/2019
Last updated
09/18/2020
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