Provider Demographics
NPI:1831183185
Name:ONIAH, WINIFRED (MD)
Entity type:Individual
Prefix:DR
First Name:WINIFRED
Middle Name:
Last Name:ONIAH
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 1:2269 W 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46404-3367
Mailing Address - Country:US
Mailing Address - Phone:219-944-4187
Mailing Address - Fax:219-944-4196
Practice Address - Street 1:2269 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46404-3367
Practice Address - Country:US
Practice Address - Phone:219-944-4187
Practice Address - Fax:219-944-4196
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057396A174400000X
IN01057396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200443050Medicaid
IN200443050Medicaid
IN113150TTTTMedicare PIN
INM400021223Medicare PIN