Provider Demographics
NPI:1063673200
Name:SOWEMIMO, FIOLAKEMI (MD)
Entity Type:Individual
Prefix:DR
First Name:FIOLAKEMI
Middle Name:
Last Name:SOWEMIMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUFIOLAKEMI
Other - Middle Name:
Other - Last Name:OJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:901 W MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2537
Mailing Address - Country:US
Mailing Address - Phone:732-252-6688
Mailing Address - Fax:732-761-9705
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-252-6688
Practice Address - Fax:732-761-9705
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249000207R00000X
NJ25MA08593300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine