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Individual
EROMOSELE ANTHONY OTOADESE
Active
Individual
EROMOSELE ANTHONY OTOADESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
28663
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2091736
—
IA
01
—
421417307C4
JOHN DEERE HEALTH INS PLA
IA
01
—
46994
WELLMARK INS PLAN
IA
Enumeration date
05/18/2006
Last updated
04/29/2020
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