Individual
DR. EMMANUEL OLUSHOLA OTABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
5501 OLD YORK ROAD, ALBERT EINSTEIN MEDICAL CENTER, PHILADELPHIA, PA 19141
(215) 456-7890
Mailing address
5501 OLD YORK ROAD, ALBERT EINSTEIN MEDICAL CENTER, PHILADELPHIA, PA 19141
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT230527
PA
Other
Enumeration date
06/05/2024
Last updated
12/05/2024
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