Odianosen Kelvin Unemin
Individual provider Active NPI Driver · Marion, IA
NPI 1962969253 · NPPES record last updated Feb 22, 2019
Key facts
- NPI
- 1962969253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 210 Ridge Dr Apt 2
Marion, IA 52302-3046 - Phone
- (832) 677-7406
- NPI assigned
- Feb 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver |
172A00000X | Yes |
Addresses
Primary practice location
210 Ridge Dr Apt 2
Marion, IA 52302-3046
Mailing address
210 Ridge Dr Apt 2
Marion, IA 52302-3046
Phone (832) 677-7406
Other providers in Marion, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.