MEDICARE: EFOSA ASEMOTA

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	163W00000X	Registered Nurse	4704333703	MI

General Provider Information

NPI Number	:	1326554932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EFOSA ASEMOTA

Provider Business Mailing Address
First Line	:	2154 KENNEDY DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2154 KENNEDY DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-2900
Country	:	US
Telephone Number	:	517-944-1929
Fax Number	:

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

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	12/19/2017

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Directions to “ EFOSA ASEMOTA ” Practice Location

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