Provider Demographics
NPI:1083933170
Name:OMERY, BILAL (MD)
Entity type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:OMERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 GERMANTOWN AVE UNIT 17A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4649
Mailing Address - Country:US
Mailing Address - Phone:219-741-2575
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST STE 130
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-3264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI61964207RC0001X
WI61964-202085R0202X
PAMT2320402085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology