Provider Demographics
NPI:1669783106
Name:IKOGHODE, HABIBA ALERO (MD)
Entity type:Individual
Prefix:DR
First Name:HABIBA
Middle Name:ALERO
Last Name:IKOGHODE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:605-328-6512
Practice Address - Street 1:1430 NORTH HWY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MN
Practice Address - Zip Code:56143-1093
Practice Address - Country:US
Practice Address - Phone:507-847-2200
Practice Address - Fax:507-847-3808
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2013-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125058258207Q00000X
MN106745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine