Eromosele Anthony Otoadese
Cardiothoracic Vascular Surgeon
1753 W Ridgeway Ave Ste 111
Waterloo
, Iowa 50701-4588
Eromosele Anthony Otoadese
Cardiothoracic Vascular Surgeon
1753 W Ridgeway Ave Ste 111
Waterloo
, Iowa 50701-4588
(319) 233-2164
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Eromosele Anthony Otoadese
- Po Box 2660
- Waterloo, IA
- Zip : 50704-2660
- Fax : (319) 233-2164
- Phone : (319) 233-6621
Second Address
- Eromosele Anthony Otoadese
- 1753 W Ridgeway Ave Ste 111
- Waterloo, IA
- Zip : 50701-4588
- Fax : (319) 233-2164
- Phone : (219) 233-6211
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 28663 | IA |
National Provider Identifier
| NPI | 1013960129 |
|---|---|
| Provider Name | Eromosele Anthony Otoadese |
| First Address | Waterloo, IA 50704-2660 |
| Second Address | Waterloo, IA 50701-4588 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/05/2006 |
| Last Update Date | 29/04/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2091736 | (05) | IA |
| 421417307C4 | JOHN DEERE HEALTH INS PLA (01) | IA |
| 46994 | WELLMARK INS PLAN (01) | IA |
| F46609 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.