Provider Demographics
NPI:1083027189
Name:E-NUNU, TORITSETIMIYIN MARIAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:TORITSETIMIYIN
Middle Name:MARIAN
Last Name:E-NUNU
Suffix:
Gender:F
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:590 MEDICAL CENTER RD
Mailing Address - Street 2:SURGERY DEPT, UROLOGY CLINIC
Mailing Address - City:FORT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8007
Mailing Address - Fax:254-288-8875
Practice Address - Street 1:590 MEDICAL CENTER RD
Practice Address - Street 2:SURGERY DEPT, UROLOGY CLINIC
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8007
Practice Address - Fax:254-288-8875
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA141063208800000X
HIMD-18334208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicare UPIN