Physician Compare National (NPI:1770816613)

HEALTHCARE PROVIDER: MAYOR ABUMERE OKOLOISE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1770816613
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0749456333
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120103000514
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OKOLOISE
	Individual professional last name
Provider First Name	MAYOR
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1365 ENGLEWOOD DR
	Group Practice or individual's line 1 address
Line 2 Street Address	HOPE MEDICAL SPECIALTIES
	Group Practice or individual's line 2 address
City	SLIDELL
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	704583009
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y