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NPI Code Detail

MEDICARE: PAPPA UMONOIBALO EHIMARE MD

MEDICARE: PAPPA UMONOIBALO EHIMARE MD
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
12084P0800XPsychiatry Physician2007016081MO

General Provider Information

NPI Number : 1730291154
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAPPA UMONOIBALO EHIMARE MD
Provider Business Mailing Address
First Line : 1800 COMMUNITY
Second Line :
City : CLINTON
State : MO
Zip : 64735-8804
Country : US
Telephone Number : 660-890-8183
Fax Number : 660-890-8183
Provider Business Practice Location Address
First Line : 1032 CROSSWINDS CT
Second Line :
City : WENTZVILLE
State : MO
Zip : 63385-4836
Country : US
Telephone Number : 888-403-1071
Fax Number : 636-332-8213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/22/2019

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