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Individual

OMAZONNA AMADI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1400 E 9TH ST, ROCHESTER, IN 46975-8931
(574) 223-2020
Mailing address
1400 E 9TH ST, ROCHESTER, IN 46975-8931
(574) 223-2020

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01087791A
IN
207Q00000X
Family Medicine Physician
309007
NY
207VX0000X
Obstetrics Physician
309007
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102674314
ANTHEM
IN
05
300065568
IN
Enumeration date
06/07/2018
Last updated
02/09/2024
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