Rachael Ehimudiamen Agbator, MD
Internal Medicine in Tupelo, MS. Individual provider (NPI-1).
NPI number1831767490
StatusActive
Last updated in NPPESAug 13, 2024
Details
- NPI
- 1831767490
- Entity type
- Individual (NPI-1)
- Name
- Rachael Ehimudiamen Agbator
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2021
- Certification date
- Aug 13, 2024
- Last updated
- Aug 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 33819 | MS | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
830 S Gloster StTupelo, MS 38801-4934
Phone 662-377-2539
Mailing address
808 Varsity DrTupelo, MS 38801-4613
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