Provider Demographics
NPI:1346305539
Name:ONAMUSI, BABATUNDE TAIWO (MD, MPH, CIME)
Entity Type:Individual
Prefix:DR
First Name:BABATUNDE
Middle Name:TAIWO
Last Name:ONAMUSI
Suffix:
Gender:M
Credentials:MD, MPH, CIME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 CONGRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4133
Mailing Address - Country:US
Mailing Address - Phone:937-312-3627
Mailing Address - Fax:937-312-3719
Practice Address - Street 1:1875 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-1835
Practice Address - Country:US
Practice Address - Phone:419-226-9720
Practice Address - Fax:419-226-9265
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH76480Medicare UPIN
OHON7311571Medicare ID - Type Unspecified