Provider Demographics
NPI:1376006460
Name:BOLARINWA, OLAYEMI (MD)
Entity Type:Individual
Prefix:
First Name:OLAYEMI
Middle Name:
Last Name:BOLARINWA
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 1:608 NW 9TH ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1014
Mailing Address - Country:US
Mailing Address - Phone:405-272-7494
Mailing Address - Fax:405-272-6985
Practice Address - Street 1:608 NW 9TH ST STE 1000
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1014
Practice Address - Country:US
Practice Address - Phone:405-272-7494
Practice Address - Fax:405-272-6985
Is Sole Proprietor?:No
Enumeration Date:2019-04-07
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34828207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine