Active NPI
Ejemenare Aimanehi Dawodu, MD
- Pediatrics Physician
- Detroit, MI
National Provider Identifier
1700549565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4351048124
- Practice address
- 22201 Moross Rd Ste 70
Detroit, MI 48236-2166 - Phone
- (313) 343-3800
- Fax
- (313) 343-4756
- NPI assigned
- Oct 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4351048124 | MI | Primary |
Addresses
Primary practice location
22201 Moross Rd Ste 70
Detroit, MI 48236-2166
Mailing address
22201 Moross Rd Ste 70
Detroit, MI 48236-2166
Phone (313) 343-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351048124 | MI | MD | Pediatrics Physician |
Interoperability endpoints
- edawodu826955@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1700549565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22201 MOROSS RD STE 70",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362166",
"telephone_number": "313-343-3800",
"fax_number": "313-343-4756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22201 MOROSS RD STE 70",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362166",
"telephone_number": "313-343-3800",
"fax_number": "313-343-4756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWODU",
"first_name": "EJEMENARE",
"middle_name": "AIMANEHI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-19",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4351048124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.