Oshea Sarwolo Poneys

Individual provider Active NPI Contractor · Homewood, AL

NPI 1043916281 · NPPES record last updated Jan 31, 2023

Key facts

NPI
1043916281
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
297 W Valley Ave Ste 9
Homewood, AL 35209-4817
Phone
(205) 908-6183
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

297 W Valley Ave Ste 9
Homewood, AL 35209-4817

Mailing address

297 W Valley Ave Ste 9
Homewood, AL 35209-4817
Phone (205) 908-6183

Other providers in Homewood, AL

All providers in Homewood, AL · Contractor in Alabama

Sources for this page

Verify at the official NPI Registry.