Individual
FIDELIS O EJIANREH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2032 E PLEASANT VALLEY BLVD, ALTOONA, PA 16602
(814) 684-3101
Mailing address
811 CRICKLEWOOD DR, STATE COLLEGE, PA 16803-1899
(814) 234-2226
(814) 234-2258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BE8240652
PA
Other
Enumeration date
01/27/2006
Last updated
03/11/2019
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