Provider Demographics
NPI:1386062776
Name:OPOKU, IFEANYIROCHUKWU GENEVA
Entity type:Individual
Prefix:
First Name:IFEANYIROCHUKWU
Middle Name:GENEVA
Last Name:OPOKU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IFEANYIROCHUWKU
Other - Middle Name:GENEVA
Other - Last Name:ANWAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1321
Mailing Address - Country:US
Mailing Address - Phone:612-262-9000
Mailing Address - Fax:
Practice Address - Street 1:2800 CHICAGO AVE STE 101
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1353
Practice Address - Country:US
Practice Address - Phone:612-333-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN67438207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program