Provider Demographics
NPI:1275981623
Name:BAKARE, OLUFUNKE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUFUNKE
Middle Name:
Last Name:BAKARE
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 1:55 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-7099
Mailing Address - Country:US
Mailing Address - Phone:614-627-1878
Mailing Address - Fax:614-855-4813
Practice Address - Street 1:55 N HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-7099
Practice Address - Country:US
Practice Address - Phone:614-898-8808
Practice Address - Fax:614-855-4813
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.137636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty