Provider Demographics
NPI:1902216427
Name:AJUFO, IJEOMA (MD)
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:
Last Name:AJUFO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:210-491-9400
Mailing Address - Fax:210-491-3550
Practice Address - Street 1:17720 CORPORATE WOODS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259
Practice Address - Country:US
Practice Address - Phone:210-491-9400
Practice Address - Fax:210-491-3550
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR53492084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry