Provider Demographics
NPI:1831659184
Name:OMATSONE, CLARE AMIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:AMIRA
Last Name:OMATSONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 S WOLCOTT AVE 6TH FLOOR BOX 5
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3704
Mailing Address - Country:US
Mailing Address - Phone:312-355-6167
Mailing Address - Fax:
Practice Address - Street 1:380 HOSPITAL DRIVE, BUILDING A
Practice Address - Street 2:SUITE 430
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8017
Practice Address - Country:US
Practice Address - Phone:478-751-0367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036165122207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology