Individual
DR. KEVIN EMITSEILU IMMANUEL
Active
Individual
DR. KEVIN EMITSEILU IMMANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003058
GA
2084N0400X
Neurology Physician
Primary
P6648
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340111901
—
TX
01
—
8FU287
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/25/2008
Last updated
05/24/2016
Update your record
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