MEDICARE: ABRAHAM O OSINBOWALE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	350497260	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043281686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM O OSINBOWALE MD

Provider Business Mailing Address
First Line	:	318 E UNIVERSITY AVE
Second Line	:	PRIMARY CARE OF CINCINNATI INC
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2431
Country	:	US
Telephone Number	:	513-961-1100
Fax Number	:	513-961-7156

Provider Business Practice Location Address
First Line	:	318 E UNIVERSITY AVE
Second Line	:	PRIMARY CARE OF CINCINNATI INC
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2431
Country	:	US
Telephone Number	:	513-961-1100
Fax Number	:	513-961-7156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	05/22/2012

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