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Individual

MICHAEL S OMORI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2213 CHERRY ST, TOLEDO, OH 43608-2603
(419) 251-3232
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35047205
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000360661
IND BC/BS # FOR ST.V-ER
OH
01
000000384591
BC/BS IND # AT ST.V-OBS
OH
05
0926556
OH
01
727078
BUCKEYE COMMUNITY #
OH
01
P00207676
RRCARE IND # ST. V-ER
OH
Enumeration date
04/13/2006
Last updated
10/17/2007
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