Idahosa, Eromonsele O.

Idahosa, Eromonsele O. is an sole proprietor health care provider with primary practice located at 8354 Little Eagle Court Suite C, Indianapolis IN 46234. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Idahosa, Eromonsele O. can be contacted via phone (317) 291-1211.

Contact Information

Primary practice address
8354 Little Eagle Court Suite C Indianapolis IN 46234
Phone: (317) 291-1211
Fax: (317) 291-1194
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01057350A Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01057350A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01057350A Indiana

Profile Details

NPI number 1588659924
LBN Legal business name Idahosa, Eromonsele O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2005
Last updated Oct 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588659924 NPPES
Indiana MEDICAID 200811720

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