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Contact Information

OMOTAYO T FAWIBE, MD
3978 NEW VISION DR
FORT WAYNE, IN46845
 Phone: 260-672-4680
 Fax: 260-458-5836
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Medicine

2083X0100X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for OMOTAYO T FAWIBE · (Male)

NPI Number 1851634554
Status Active
Credentials MD
Entity Individual
Enumeration date 04/01/2013
Last updated 07/24/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01076903A
  • TX License # S5894
Hospital affiliation(s) Not Available
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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