Provider Demographics
NPI:1568158350
Name:DIALLO, OUMOUL
Entity Type:Individual
Prefix:
First Name:OUMOUL
Middle Name:
Last Name:DIALLO
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 1:1821 WALNUT HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3173
Mailing Address - Country:US
Mailing Address - Phone:614-390-7028
Mailing Address - Fax:
Practice Address - Street 1:1531 PERRY ST APT 16
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-2672
Practice Address - Country:US
Practice Address - Phone:614-390-7028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide