Individual
DR. ANTHONY ORIA AMIEWALAN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACOG
Contact information
Practice address
1750 EAST LAKE SHORE DR, SUITE 320, DECATUR, IL 62521
(217) 422-0560
(217) 422-0872
Mailing address
2965 N MAIN ST STE A2969N, DECATUR, IL 62526-4392
(217) 422-0560
(217) 422-0872
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036112019
IL
207VX0000X
Obstetrics Physician
036112019
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112019
—
IL
05
—
1669486668
—
IL
05
—
270591128
—
IL
Enumeration date
07/28/2006
Last updated
03/24/2025
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