Individual
OMOKAYODE A. OSOBAMIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16151 19 MILE RD STE 302, CLINTON TWP, MI 48038-1159
(586) 228-7433
Mailing address
PO BOX 82057, ROCHESTER, MI 48308-2057
(586) 228-7433
(248) 693-9204
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301059326
MI
207RN0300X
Nephrology Physician
4301059326
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10 4841551
—
MI
01
—
1105018352
BCBSM
MI
Enumeration date
09/06/2005
Last updated
04/10/2024
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