Provider Demographics
NPI:1366038036
Name:UMOYE, ABOSEDE MOPELOLA
Entity Type:Individual
Prefix:
First Name:ABOSEDE
Middle Name:MOPELOLA
Last Name:UMOYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37499 LANG CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-9300
Mailing Address - Country:US
Mailing Address - Phone:313-422-3745
Mailing Address - Fax:
Practice Address - Street 1:37499 LANG CT
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-9300
Practice Address - Country:US
Practice Address - Phone:313-422-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI802210790251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health