Organization
PEARL MEDICAL PRACTICE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSAWARU OMORUYI M.D. (PRESIDENT)
(502) 456-0494
Entity
Organization
Contact information
Practice address
4200 GARDINER VIEW AVE, SUITE 200, LOUISVILLE, KY 40213-1877
(502) 456-0494
(502) 456-0496
Mailing address
4200 GARDINER VIEW AVE, SUITE 200, LOUISVILLE, KY 40213-1877
(502) 456-0494
(502) 456-0496
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100259660
—
KY
05
—
7100267920
—
KY
Enumeration date
11/15/2012
Last updated
10/02/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us