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Contact Information

EBELE C ODONWODO, MD
100 MICHIGAN ST NE
SUITE A721
GRAND RAPIDS, MI49503-2560
 Phone: 616-391-3139
 Fax: 616-391-3044
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for EBELE C ODONWODO · (Male)

NPI # 1336331891
Status Active
Credentials MD
Entity Individual
Enumeration date 08/17/2007
Last updated 09/26/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301097441
  • MI Medicaid 1336331891
  • MI Other 1417961137 BCBSM - BMH
Hospital affiliation(s)
  • JEWISH HOSPITAL LLC - (Acute Care)
    4777 EAST GALBRAITH ROAD
    CINCINNATI, OH 45236
  • MERCY FRANCISCAN HOSPITAL - MT AIRY - (Acute Care)
    3300 MERCY HEALTH BLVD
    CINCINNATI, OH 45211
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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