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Organization
OMNI FAMILY MEDICAL CLINIC SC
Active
Organization
OMNI FAMILY MEDICAL CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABALO NUNYAKPE MD (OWNER PRESIDENT)
(414) 586-9255
Entity
Organization
Contact information
Practice address
7810 WEST GOOD HOPE ROAD, MILWAUKEE, WI 53223
(414) 586-9255
(414) 586-9282
Mailing address
4555 WEST SCHROEDER DR, SUITE 170, MILWAUKEE, WI 53223
(414) 365-3210
(414) 365-3225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21290800
—
WI
Enumeration date
05/24/2006
Last updated
04/01/2008
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