| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MMEYENEABASI DAVID OMEDE | 1568023828 | 2022-06-26 |
Mmeyeneabasi David Omede is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1568023828. Registration indicates Mmeyeneabasi David Omede is a provider of access to pediatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Pediatrics (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics: Pediatric Gastroenterology, ) (Specialist Network, ) (Pediatrics Pediatric Gastroenterology, Allopathic & Osteopathic Physicians) (Pediatrics, )
| Entity Type | Individual |
| Provider Name | Mrs. Mmeyeneabasi David Omede M.D. |
| Other Provider Name | Mrs. Mmeyeneabasi David Essien |
| Practice Office Address | 55 FRUIT ST BOSTON, MA US |
| Practice Office Telephone | 6176437972 |
| Mailing Address | 55 FRUIT ST BOSTON, MA 021142621 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 55 Fruit St | Boston, MA 021142696 | 6176437972 |
| 450 Clarkson Avenue, SUNY Downstate Medical Center | Brooklyn, NY 11203 | 8004553203 |
| Code | Practice | License No State |
|---|---|---|
| 208000000X | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 292199
MA |
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 2080P0206X PRIMARY | Allopathic & Osteopathic Physicians Pediatrics Pediatrics: Pediatric Gastroenterology Specialist Network Pediatrics Pediatric Gastroenterology Allopathic & Osteopathic Physicians Pediatrics | 292199
MA |