Individual
DR. AGNES O OVIENMHADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5102 W CAMPBELL AVE, PHOENIX, AZ 85031
(623) 848-5000
Mailing address
8620 N 22ND AVE, 200, PHOENIX, AZ 85021
(602) 674-6506
(602) 674-6512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37916
AZ
208M00000X
Hospitalist Physician
37916
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367600
—
AZ
Enumeration date
05/02/2007
Last updated
10/02/2009
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