Provider Demographics
NPI:1497864169
Name:ATTIPOE, NOBEL DZORGBENYAH (MD)
Entity type:Individual
Prefix:MR
First Name:NOBEL
Middle Name:DZORGBENYAH
Last Name:ATTIPOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DZORGBENYAH
Other - Middle Name:NOBEL
Other - Last Name:ATTIPOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3502 W. NORTHSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213
Mailing Address - Country:US
Mailing Address - Phone:601-362-5321
Mailing Address - Fax:601-362-5321
Practice Address - Street 1:3502 W. NORTHSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213
Practice Address - Country:US
Practice Address - Phone:601-362-5321
Practice Address - Fax:601-362-5321
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226843207V00000X
MS19183207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87673Medicare UPIN