MEDICARE: DR. GEOFFREY O OUMA DO

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	207RC0000X	Cardiovascular Disease Physician	34014209	OH

General Provider Information

NPI Number	:	1386845006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEOFFREY O OUMA DO

Provider Business Mailing Address
First Line	:	111 S 11TH ST
Second Line	:	SUITE 6270
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # J3-5
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-4824
Country	:	US
Telephone Number	:	216-445-7308
Fax Number	:	216-636-6955

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	09/19/2024

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