Odibo, Anthony Omavuaye

Odibo, Anthony Omavuaye is an individual health care provider with primary practice located at 4901 Forest Park Ave Div Obgyn Mfm And Us, Ste 710, Saint Louis MO 63108-1495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine, which is considered as his primary health care specialty. Odibo, Anthony Omavuaye can be contacted via phone (314) 454-8181.

Contact Information

Primary practice address
4901 Forest Park Ave Div Obgyn Mfm And Us, Ste 710 Saint Louis MO 63108-1495
Phone: (314) 454-8181
Fax: (314) 747-1429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Maternal & Fetal Medicine 207VM0101X 2021013428 Missouri

Profile Details

NPI number 1700889516
LBN Legal business name Odibo, Anthony Omavuaye
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Apr 25th, 2024 - about 7 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700889516 NPPES
Missouri MEDICAID 207611005

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