Ehikioya Osamudiamen Osemobor, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101245516 Issued in VA

Practice address

2460 Lee Highway
Pulaski, VA 24301

Phone

(540) 980-8804

Fax

(540) 980-8161

NPI assigned

May 29, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1366677791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 TOWN CENTER DR",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240846069",
            "telephone_number": "540-616-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 LEE HIGHWAY",
            "city": "PULASKI",
            "state": "VA",
            "postal_code": "24301",
            "telephone_number": "540-980-8804",
            "fax_number": "540-980-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSEMOBOR",
        "first_name": "EHIKIOYA",
        "middle_name": "OSAMUDIAMEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-29",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101245516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Pulaski, VA
• Providers in Pulaski, VA by specialty
• Internal Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.