Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC006703 | PA |
Y | 222Z00000X | Podiatrist | SC006703 | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC006703 | PA |
NPI | 1083157366 |
---|---|
Provider Name | Oumou Belemou |
First Address | Enola, PA 17025-1233 |
Second Address | Enola, PA 17025-1233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2016 |
Last Update Date | 07/04/2021 |