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Sourou Midodjiho

NPI 1700799129 · on the registry since 2026 · sole proprietor

Practice

Address
4012 Raynor Pkwy Apt 125
Bellevue, NE 68123
Phone
(402) 612-2547
Clinicians at this address
2

Registry record

Primary taxonomy
3747P1801X
3747P1801X
Licence states on file
NULL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-09-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nebraska