Provider Demographics
NPI:1033361662
Name:LIMANN, BOLANLE ASUNI (MD)
Entity Type:Individual
Prefix:DR
First Name:BOLANLE
Middle Name:ASUNI
Last Name:LIMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BOLANLE
Other - Middle Name:RASHEEDAT
Other - Last Name:ASUNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1123
Mailing Address - Country:US
Mailing Address - Phone:717-232-9971
Mailing Address - Fax:
Practice Address - Street 1:110 S 17TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1123
Practice Address - Country:US
Practice Address - Phone:717-232-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD435523207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102308446-0010Medicaid
PA102308446-0011Medicaid
PA102308446-0016Medicaid
PA102308446Medicaid
PA102308446-0013Medicaid
PA102308446-0015Medicaid
PA102308446-0012Medicaid