Omoba, Emmanuel A

Omoba, Emmanuel A is an individual health care provider with primary practice located at 509 W University Ave , Urbana IL 61801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Omoba, Emmanuel A can be contacted via phone (217) 383-2010.

Contact Information

Primary practice address
509 W University Ave Urbana IL 61801
Phone: (217) 383-2010
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 63114 Minnesota
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 33539 Wisconsin
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD-44772 Iowa
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-2206 Guam
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036085089 Illinois

Profile Details

NPI number 1346342342
LBN Legal business name Omoba, Emmanuel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated May 27th, 2022 - about 2 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 1346342342 NPPES
Wisconsin MEDICAID 32447500

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