Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 350497260 | OH |
NPI | 1043281686 |
---|---|
Provider Name | Abraham O Osinbowale |
First Address | Cincinnati, OH 45219-2431 |
Second Address | Cincinnati, OH 45219-2431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0962203 | (05) | OH |
A81752 | (02) |