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Individual

STEPHEN OMOBUDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3413 DESOTA AVE, CLEVELAND HTS, OH 44118
(216) 738-1255
(216) 738-1255
Mailing address
3413 DESOTA AVE, CLEVELAND HTS, OH 44118
(216) 738-1255
(216) 738-1255

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
STNA 400457110205
376J00000X
Homemaker
STNA 400457110205
376K00000X
Nurse's Aide
STNA 400457110205

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1807192
ODMRDD CONTRACT #
OH
05
2564014
OH
Enumeration date
03/01/2007
Last updated
09/11/2025
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