Provider Demographics
NPI:1932368768
Name:OKORODUDU, DANIEL ESIMAJURONO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ESIMAJURONO
Last Name:OKORODUDU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 INWOOD RD
Practice Address - Street 2:8TH AND 9TH FL
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8872
Practice Address - Country:US
Practice Address - Phone:214-645-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01118207RE0101X
TXQ5055207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC4253BMedicare PIN