Provider Demographics
NPI:1831291848
Name:ONI, RICHARD O (MD INC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:O
Last Name:ONI
Suffix:
Gender:M
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5525 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2782
Mailing Address - Country:US
Mailing Address - Phone:219-884-1551
Mailing Address - Fax:219-887-6334
Practice Address - Street 1:5525 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2782
Practice Address - Country:US
Practice Address - Phone:219-884-1551
Practice Address - Fax:219-887-6334
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030980A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200014830AMedicaid
IN100166600AMedicaid
IN000000085298OtherBCBS OF INDIANA
IL91107850OtherBCBS OF ILL
IL91107850OtherBCBS OF ILL
INB29084Medicare UPIN
IN0891670001Medicare NSC
IN100166600AMedicaid
IN200014830AMedicaid
IN200014830BMedicaid