Individual
OMUWA BRAIMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 GATEWAY CT, WEST BEND, WI 53095
(262) 335-8600
Mailing address
1100 GATEWAY CT, WEST BEND, WI 53095-8539
(262) 335-8600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
67105-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100065610
—
WI
Enumeration date
03/25/2015
Last updated
07/23/2024
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