Provider Demographics
NPI:1558158089
Name:EKANEM, UDUAK-OBONG INIABASI
Entity type:Individual
Prefix:
First Name:UDUAK-OBONG
Middle Name:INIABASI
Last Name:EKANEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 S ROBERTSON ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2807
Mailing Address - Country:US
Mailing Address - Phone:504-988-3591
Mailing Address - Fax:504-988-3591
Practice Address - Street 1:131 S ROBERTSON ST STE 1300
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2807
Practice Address - Country:US
Practice Address - Phone:504-988-3591
Practice Address - Fax:504-988-3591
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program