Donovan M Ogboh, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101025038 Issued in MI

Practice address

27472 Schoenherr Rd Ste 100
Warren, MI 48088-6675

Phone

(586) 751-8844

Fax

(586) 751-8596

NPI assigned

May 3, 2018

Last updated

Jan 5, 2023By the provider in NPPES

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 18, 2025 through Jul 18, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1407345622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886675",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBOH",
        "first_name": "DONOVAN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101025038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Warren, MI
• Providers in Warren, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.