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Organization

OMNI FAMILY MEDICAL CLINIC SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ABALO NUNYAKPE MD (OWNER PRESIDENT)
(414) 586-9255
Entity
Organization

Contact information

Practice address
7810 WEST GOOD HOPE ROAD, MILWAUKEE, WI 53223
(414) 586-9255
(414) 586-9282
Mailing address
4555 WEST SCHROEDER DR, SUITE 170, MILWAUKEE, WI 53223
(414) 365-3210
(414) 365-3225

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21290800
WI
Enumeration date
05/24/2006
Last updated
04/01/2008
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