Healthcare Provider Details
I. General information
NPI: 1477698991
Provider Name (Legal Business Name): RICHARD O. ONI, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2007
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5525 BROADWAY
MERRILLVILLE IN
46410-2782
US
IV. Provider business mailing address
5525 BROADWAY
MERRILLVILLE IN
46410-2782
US
V. Phone/Fax
- Phone: 219-884-1551
- Fax: 219-887-6334
- Phone: 219-884-1551
- Fax: 219-887-6334
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 01030980A |
| License Number State | IN |
VIII. Authorized Official
Name: DR.
RICHARD
O
ONI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-884-1551