Provider Demographics
NPI:1285016956
Name:OLORUNFEMI, PAUL ODUNAYO (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ODUNAYO
Last Name:OLORUNFEMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6709 E SOUTHERN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3738
Mailing Address - Country:US
Mailing Address - Phone:804-773-2220
Mailing Address - Fax:480-378-2440
Practice Address - Street 1:6709 E SOUTHERN AVE STE 100
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3738
Practice Address - Country:US
Practice Address - Phone:804-773-2220
Practice Address - Fax:480-378-2440
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ67599207U00000X, 207RC0000X, 207RI0011X
FLME136997208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology