Odigie, Omorovbiye T

Odigie, Omorovbiye T is an individual health care provider with primary practice located at 680 Centre St , Brockton MA 02302-3308. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Odigie, Omorovbiye T can be contacted via phone (508) 894-0400.

Contact Information

Primary practice address
680 Centre St Brockton MA 02302-3308
Phone: (508) 894-0400
Fax: (508) 941-6200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2135 Massachusetts

Profile Details

NPI number 1215122478
LBN Legal business name Odigie, Omorovbiye T
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2007
Last updated May 22nd, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215122478 NPPES
Massachusetts Other 2135 LICENSE
Massachusetts Other 51484 LICENSE

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