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Contact Information

OSITA V EZEAKUDO, MD
2510 E DUPONT RD
SUITE 200
FORT WAYNE, IN46825-1601
 Phone: 260-432-4913
 Fax: 260-969-6832
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for OSITA V EZEAKUDO · (Male)

NPI # 1013078351
Status Active
Credentials MD
Entity Individual
Enumeration date 12/12/2006
Last updated 01/31/2018 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IN License # 01065437A
  • IN Medicaid 200910310
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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