Provider Demographics
NPI:1033710165
Name:DINAKIN, OLUFEMI
Entity Type:Individual
Prefix:
First Name:OLUFEMI
Middle Name:
Last Name:DINAKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:FEMI
Other - Middle Name:
Other - Last Name:DINAKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4950 PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-5216
Mailing Address - Country:US
Mailing Address - Phone:540-283-5108
Mailing Address - Fax:540-283-5102
Practice Address - Street 1:4950 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-5216
Practice Address - Country:US
Practice Address - Phone:540-283-5108
Practice Address - Fax:540-283-5102
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210561183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist