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Organization

OMOTAYO FAWIBE MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OMOTAYO FAWIBE (OWNER)
(832) 606-7941
Entity
Organization

Contact information

Practice address
14726 AMERA CIR, FORT WAYNE, IN 46845-0027
(832) 606-7941
Mailing address
14726 AMERA CIR, FORT WAYNE, IN 46845-0027

Taxonomy

Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary

Other

Enumeration date
12/09/2021
Last updated
12/09/2021
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