Imudia Dekonte Ehanire (NPI# 1427285311, PAC ID# 2466741640) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1427285311 |
| PAC ID by PECOS | 2466741640 |
| Professional Enrollment ID | I20160912000121 |
| Full Name | Imudia Dekonte Ehanire |
| Organization Legal Name | SOUTHWEST MEDICAL CENTER |
| Address |
305 W 15th St 102 Southwest Professional Physicians Liberal KS 67901-2455 |
| Phone Number | 6206240702 |
| Gender | F |
| Medical School | HOWARD UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2009 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 7517941651 |
| Number of Group Practice Members | 28 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170068 | SOUTHWEST MEDICAL CENTER |
| 351335 | JAMESTOWN REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 | 6206240702 | SOUTHWEST MEDICAL CENTER |
| Organization Legal Name | SOUTHWEST MEDICAL CENTER |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan M Furnish | Certified Nurse Midwife (cnm) | Southwest Medical Center | 623 Ave C, Beaver, OK 73932-3126 |
| Jose A Maeda | General Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Jacqueline Anne Woodrum | Family Medicine | Southwest Medical Center | 555 W 15th St, Liberal, KS 67901-2467 |
| Victoria Rachel Underwood | Nurse Practitioner | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Firas I. Kawtharani | Orthopedic Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Linsey K Carter | Nurse Practitioner | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Roman Pohorecki | Anesthesiology | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Nchang Mantoh Azefor | General Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Bruce Wayne Cook | Certified Registered Nurse Anesthetist (crna) | Southwest Medical Center | 315 W 15th St, Southwest Medical Center Anesthesia, Liberal, KS 67901-2455 |
| John C Peeden | Certified Registered Nurse Anesthetist (crna) | Southwest Medical Center | 315 W 15th St, Southwest Medical Center Anesthesia, Liberal, KS 67901-2455 |
| Street Address |
305 W 15TH ST 102 SOUTHWEST PROFESSIONAL PHYSICIANS |
| City | LIBERAL |
| State | KS |
| Zip | 67901-2455 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jose A Maeda | General Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Victoria Rachel Underwood | Nurse Practitioner | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Firas I. Kawtharani | Orthopedic Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Linsey K Carter | Nurse Practitioner | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Roman Pohorecki | Anesthesiology | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Nchang Mantoh Azefor | General Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Pingal Anilbhai Desai | Orthopedic Surgery | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Britt N Short | Nurse Practitioner | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Van Tuong Trinh | Family Medicine | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Lamberto O Flores | Obstetrics/gynecology | Southwest Medical Center | 305 W 15th St, 102 Southwest Professional Physicians, Liberal, KS 67901-2455 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Suhail A Ansari | Orthopedic Surgery | 2138 N Kansas Ave, Liberal, KS 67901-2012 | |
| Steven Douglas Graham | Optometry | Vision Source of Liberal Inc | 2136 N Kansas Ave, Liberal Kansas, KS 67901-2012 |
| Rhiannon Radcliff | Optometry | Vision Source of Liberal Inc | 2136 N Kansas Ave, Liberal Kansas, KS 67901-2012 |
| Elizabeth Ann Fieser | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| James S Jury | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| Ryan R Farrar | Optometry | Jury, Farrar and Associates, Doctors of Optometry, Pa | 2381 N Kansas Ave, Liberal, KS 67901-2055 |
| Molly Rachow | Physical Therapy | 111 Lilac Dr, Liberal, KS 67901-2058 | |
| Brandi L Boller | Family Medicine | 11 W Pkwy Blvd, Liberal, KS 67901-2081 | |
| Michael J Fulton | Optometry | 250 E Tucker Rd, Suite B, Liberal, KS 67901-2188 | |
| Varinder S Gill | Internal Medicine | 111 E Tucker Rd, Suite F, Liberal, KS 67901-2191 | |
| Find all physicians in zip 67901 | |||
| City | LIBERAL |
| Zip Code | 67901 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LIBERAL + GENERAL SURGERY |
Please comment or provide details below to improve the information on Imudia Dekonte Ehanire.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.