Provider Demographics
NPI:1720045271
Name:ONYEKABA, JOYCE IHIOMA (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:IHIOMA
Last Name:ONYEKABA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3724
Mailing Address - Country:US
Mailing Address - Phone:612-871-4354
Mailing Address - Fax:612-872-4343
Practice Address - Street 1:1925 1ST AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3724
Practice Address - Country:US
Practice Address - Phone:612-871-4354
Practice Address - Fax:612-872-4343
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0407266OtherMEDICA
MNHP11163OtherHEALTHPARTNERS
MN438R5ONOtherBLUES
MN171021OtherUCARE
MN057222500Medicaid
MN110009687Medicare ID - Type UnspecifiedMEDICARE