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1588017560
KOMIVI WOMITSO
LAFAYETTE, IN
NPI
1588017560
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01084238A)
Enumeration Date
2016-07-14
Last Update Date
2023-09-29
Business Address
KOMIVI WOMITSO MD
2708 FERRY ST
LAFAYETTE, IN 47904-3021
Phone number: 765-449-1555
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Mailing Address
KOMIVI WOMITSO MD
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800
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