Individual provider · Type 1 NPI

Anita Ebanihita Omodiagbe, MD

Student in an Organized Health Care Education/Training Program · Detroit, MI

NPI number 1659216570 Active

Practice location

6071 W Outer Drive
Detroit, MI 48235

Call (313) 966-3250 Map

Mailing address

474 Provident Way, Unit 46
Mount Hope, ONTARIO LOR 1W0

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1659216570

Anita Ebanihita Omodiagbe, MD's National Provider Identifier is 1659216570, issued on Apr 20, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Detroit, MI. The record was last updated on Apr 20, 2026.