Individual
ANITA EBANIHITA OMODIAGBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6071 W OUTER DRIVE, DETROIT, MI 48235
(313) 966-3250
Mailing address
474 PROVIDENT WAY, UNIT 46, MOUNT HOPE, ONTARIO LOR 1-W0
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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