Individual
IYARE E IZEVBAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(780) 983-7765
Mailing address
321 BUCHANAN WAY NW, EDMONTON, ALBERTA T6G2B-7
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
105698
MN
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
54450
MN
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
Primary
91802
GA
390200000X
Student in an Organized Health Care Education/Training Program
390200000X
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
05/05/2009
Last updated
06/06/2022
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