STEPHEN OMOBUDE NPI 1124156286

NPI Information

NPI: 1124156286
Provider Name: STEPHEN OMOBUDE
Classification: Driver - 172A00000X
Entity Type: Individual
Address:
3413 DESOTA AVE
CLEVELAND HTS, OH
ZIP 44118
Phone: (216) 738-1255
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Stephen Omobude is a driver in Cleveland Hts, OH. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. Stephen Omobude NPI is 1124156286. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3413 DESOTA AVE
CLEVELAND HTS, OH
ZIP 44118
Phone: (216) 738-1255
Fax: (216) 738-1255

The enumeration date for this NPI number is 3/1/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	Primary
1	172A00000X	Driver	STNA 400457110205	Yes
2	376J00000X	Homemaker	STNA 400457110205	X
3	376K00000X	Nurse's Aide	STNA 400457110205	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1807192	OTHER	OHIO	ODMRDD CONTRACT #
2	2564014	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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