Provider Demographics
NPI:1932591849
Name:ALAWURU, EMUOBOR
Entity type:Individual
Prefix:
First Name:EMUOBOR
Middle Name:
Last Name:ALAWURU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7881 MILL CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5807
Mailing Address - Country:US
Mailing Address - Phone:513-356-1897
Mailing Address - Fax:
Practice Address - Street 1:4287 TYLERS ESTATES DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-8534
Practice Address - Country:US
Practice Address - Phone:513-356-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401196840211376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0903660Medicaid