Individual
IJEOMA A AZODO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 DUDLEY ST, SUITE 470, PROVIDENCE, RI 02905-3236
(401) 272-1800
(401) 435-7069
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
47608
MN
208600000X
Surgery Physician
Primary
MD144117
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
949648300
—
MN
Enumeration date
01/20/2006
Last updated
09/12/2013
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