Provider Demographics
NPI:1326765173
Name:OBI, DENNIS EMEKA
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:EMEKA
Last Name:OBI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10931 E INDEP BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5057
Mailing Address - Country:US
Mailing Address - Phone:980-446-7730
Mailing Address - Fax:
Practice Address - Street 1:10931 E INDEP BLVD STE G
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5057
Practice Address - Country:US
Practice Address - Phone:980-446-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver