Provider Demographics
NPI:1508270372
Name:AGBROKO, OGHENERO SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:OGHENERO
Middle Name:SOLOMON
Last Name:AGBROKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11385 CHEYENNE TRL
Mailing Address - Street 2:APT 303
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-1998
Mailing Address - Country:US
Mailing Address - Phone:347-301-2385
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF GENERAL SURGERY
Practice Address - Street 2:CLEVELAND CLINIC
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301501799207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program