Masha, Omodele Julie
Masha, Omodele Julie is an individual health care provider with primary practice located at 518 Brookdale Dr , Statesville NC 28677-4108. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Masha, Omodele Julie can be contacted via phone (704) 872-9595.Contact Information
Primary practice address
518 Brookdale Dr
Statesville NC 28677-4108
Phone: (704) 872-9595
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2009-01717 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2009-01717 | North Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2009-01717 | North Carolina |
Profile Details
| NPI number | 1528164324 |
|---|---|
| LBN Legal business name | Masha, Omodele Julie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Mar 17th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528164324 | NPPES |
| Mississippi | MEDICAID | 09430542 | |
| Mississippi | Other | 154VV | |
| Mississippi | MEDICAID | 1051675 | |
| Mississippi | MEDICAID | NC1004 | |
| Mississippi | MEDICAID | 1528164324 |
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