Individual provider · NPI-1

Ijeoma A Azodo, M.D.

Surgery · Providence, RI

NPI number1730169194
StatusActive
Last updated in NPPESSep 12, 2013

Details

NPI
1730169194
Entity type
Individual (NPI-1)
Name
Ijeoma A Azodo
Credential
M.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jan 20, 2006
Last updated
Sep 12, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X SurgeryMD144117RIYes
208600000X Surgery47608MN

Practice location

2 Dudley St
Suite 470
Providence, RI 02905-3236

Phone 401-272-1800 · Fax 401-435-7069

Mailing address

Po Box 16149
Rumford, RI 02916-0697

Phone 401-453-9625 · Fax 401-435-7069

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