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Individual

DR. CHUKWUMA SOYINKA OSIFESO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9900 N CENTRAL EXPY STE 215, DALLAS, TX 75231-0929
(214) 396-4950
Mailing address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-122832
OH
207R00000X
Internal Medicine Physician
57.019023
OH
207RN0300X
Nephrology Physician
Primary
T3354
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0101323
OH
Enumeration date
08/16/2011
Last updated
07/07/2022
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