Healthcare Provider Details

I. General information

NPI: 1346305539
Provider Name (Legal Business Name): BABATUNDE TAIWO ONAMUSI M.D, MPH, CIME
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 S DIXIE HWY
LIMA OH
45804-1835
US

IV. Provider business mailing address

332 CONGRESS PARK DR
DAYTON OH
45459-4133
US

V. Phone/Fax

Practice location:
  • Phone: 419-226-9720
  • Fax: 419-226-9265
Mailing address:
  • Phone: 937-312-3627
  • Fax: 937-312-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: