Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01042827A | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 10142827 | IN |
N | 207VX0000X | Obstetrician | 01042827A | IN |
NPI | 1063404812 |
---|---|
Provider Name | Dr. Emmanuel Ojomo |
First Address | Dyer, IN 46311-0800 |
Second Address | Hammond, IN 46320-1931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 02/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0090000854 | BCBS GROUP NUMBER (01) | IL |
100462370 | (05) | IN |
A59170 | (02) |