| Numedical & Psychiatry Clinic | |
|
6547 N Academy Blvd # 1085 Colorado Springs CO 80918-8342 | |
| (719) 413-5005 | |
| Not Available |
| Full Name | Numedical & Psychiatry Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 6547 N Academy Blvd # 1085, Colorado Springs, Colorado |
| Authorized Official Name and Position | Modupe Mary Okonofua (DR.) |
| Authorized Official Contact | 8178059137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Numedical & Psychiatry Clinic 7244 Boreal Dr Colorado Springs CO 80915-3766 Ph: (719) 413-5005 | Numedical & Psychiatry Clinic 6547 N Academy Blvd # 1085 Colorado Springs CO 80918-8342 Ph: (719) 413-5005 |
| NPI Number | 1609340777 |
|---|---|
| Provider Enumeration Date | 01/11/2019 |
| Last Update Date | 06/04/2021 |
| Certification Date | 06/04/2021 |
| Medicare PECOS PAC ID | 2466879713 |
|---|---|
| Medicare Enrollment ID | O20200910002379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609340777 | NPI | - | NPPES |
| Provider Name | Modupe M Okonofua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215325535 PECOS PAC ID: 2466764758 Enrollment ID: I20191204000130 |
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