Provider Demographics
NPI:1538555248
Name:ERUEMULOR, ALEOBE (MD)
Entity type:Individual
Prefix:
First Name:ALEOBE
Middle Name:
Last Name:ERUEMULOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15111 HIGHWAY 165
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72142
Mailing Address - Country:US
Mailing Address - Phone:501-552-7999
Mailing Address - Fax:
Practice Address - Street 1:15111 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:AR
Practice Address - Zip Code:72142
Practice Address - Country:US
Practice Address - Phone:501-552-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-11473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine