Provider Demographics
NPI:1366626343
Name:UFEARO, HILARY IKENNA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:IKENNA
Last Name:UFEARO
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIRCLE, #1600
Mailing Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA SPECIALTIES/ONCOLOGY
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-4907
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRACARE CIRCLE, #1600
Practice Address - Street 2:CENTRACARE CLINIC HEALTH PLAZA SPECIALTIES/ONCOLOGY
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD66182208M00000X
MNMN-TEMP104791207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist