DR. ADEBOWALE ANSELM OBAITAN (NPI# 1518952142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518952142 |
| Entity Type | Individual |
| Full Name | DR. ADEBOWALE ANSELM OBAITAN |
| Credential | MD |
| Practice Address |
1430 Luckenbach Dr Allen TX 75013-4632 |
| Practice Telephone | 9723908133 |
| Practice Fax Number | 9723909258 |
| Mailing Telephone | 9723908133 |
| Mailing Fax Number | 9723909258 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2007-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 051994 | GA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | M6319 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | TRICARE SOUTH | 2211482626 | 01 |
| GA | 688786920C | 05 | |
| GA | BCBS | 52025889003 | 01 |
| Street Address |
1430 LUCKENBACH DR |
| City | ALLEN |
| State | TX |
| Zip Code | 75013-4632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184822074 | Cheryl-ann Monteiro | Internal Medicine | 1430 Luckenbach Dr, Allen, TX 75013-4632 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366059230 | Alla Al-habib Md Pllc | Psychiatry & Neurology | 981 Sh 121, Suite 3100, Allen, TX 75013 | 2020-09-25 |
| 1457968430 | Park Ventura Endoscopy Center, LLC | Clinic/Center | 981 State Highway 121, Suite 2100, Allen, TX 75013 | 2020-09-24 |
| 1689288342 | Nortex Medical Group | General Practice | 981 State Highway 121 Ste 4150, Allen, TX 75013 | 2020-09-01 |
| 1417569807 | Navaneetha Brindha Natchimuthu Dds, Pllc | Dentist | 880 W Exchange Parkway, Building A, Suite 140, Allen, TX 75013 | 2020-08-18 |
| 1225647423 | Fivestar Pulmonary Associates Pllc | Internal Medicine | 981 State Hwy 121, Ste 3100, Allen, TX 75013 | 2020-07-24 |
| 1497363741 | Pharmestate LLC | Pharmacy | 317 Central Expressway North, Allen, TX 75013 | 2020-07-22 |
| 1265063002 | Paul-douglas Walters | Clinic/Center | 1101 Raintee Circle, Suite 130, Allen, TX 75013 | 2020-01-30 |
| 1043840069 | Thrive Dental Allen Pllc | Dentist | 1010 W Exchange Pkwy, #130, Allen, TX 75013 | 2020-01-17 |
| 1023578952 | Keri Owens | In Home Supportive Care | 1823 Valencia Drive, Allen, TX 75013 | 2019-03-25 |
| 1639636939 | The Children's Dentist of Allen | Dentist | 261 W. Exchange Pkwy., Allen, TX 75013 | 2019-02-23 |
| Find all providers in zip 75013 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891981536 | Benjamin Edward Crabb | Emergency Medicine | 190 E. Stacy Rd, Ste 306 - 116, Allen, TX 75002 | 2007-09-17 |
| 1316051782 | Joseph Starr Fagner | Emergency Medicine | 304 W Boyd Dr Unit 915, Allen, TX 75013-2678 | 2006-08-19 |
| 1548609639 | Sherryl Denise Shipes | Emergency Medicine | 1218 W Mcdermott Dr, Allen, TX 75013-6304 | 2013-06-21 |
| 1265475453 | Stephan M Kramer | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-14 |
| 1427090554 | Eden T Yang | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-12 |
| 1790727899 | James Wyrick | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-12 |
| 1467494344 | Nisarg N Shah | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-12 |
| 1992745517 | Sean D Fleming | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-08 |
| 1992745558 | John A Cox | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-08 |
| 1326088956 | Jonathan Franklin | Emergency Medicine | 1105 Central Expy N, Allen, TX 75013-6103 | 2006-06-08 |
| Find all providers in ALLEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.