Provider Demographics
NPI:1184471286
Name:OBIEJESIE, ONYENMA EKELEMNNA (MBBS)
Entity type:Individual
Prefix:DR
First Name:ONYENMA
Middle Name:EKELEMNNA
Last Name:OBIEJESIE
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FRUIT STREET, MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - Street 2:DEPARTMENT OF MEDICINE, GRAY BIGELOW BUILDING 7-730
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-643-0596
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT STREET, MASSACHUSETTS GENERAL HOSPITAL
Practice Address - Street 2:DEPARTMENT OF MEDICINE, GRAY BIGELOW BUILDING 7-730
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-643-0596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA3016294390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program