Provider Demographics
NPI:1447415518
Name:ONUMA, KALU IREKE (MD,)
Entity Type:Individual
Prefix:
First Name:KALU
Middle Name:IREKE
Last Name:ONUMA
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Gender:M
Credentials:MD,
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11155 DUNN RD STE 312E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6111
Mailing Address - Country:US
Mailing Address - Phone:314-953-8500
Mailing Address - Fax:314-355-1070
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:STE 312E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-953-8500
Practice Address - Fax:314-355-1070
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20120034872084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry