MEDICARE: DR. OSIGBEMHE IYALOMHE MD,PHD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2085R0001X	Radiation Oncology Physician	MD468346	PA
3	2085R0202X	Diagnostic Radiology Physician	MD468346	PA

General Provider Information

NPI Number	:	1740634823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSIGBEMHE IYALOMHE MD,PHD

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 MONUMENT RD STE 201
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17403-5074
Country	:	US
Telephone Number	:	717-812-4083
Fax Number	:	717-812-2244

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

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	03/24/2026

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