Individual
KELECHI MELVIN ORIAKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 443-7552
(774) 441-6086
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7422
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MA
Enumeration date
06/20/2019
Last updated
11/10/2020
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