Provider Demographics
NPI:1467460410
Name:OKUNDAYE, IFUEKO BELINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:IFUEKO
Middle Name:BELINDA
Last Name:OKUNDAYE
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 1:1540 LYON DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-5069
Mailing Address - Country:US
Mailing Address - Phone:920-727-4946
Mailing Address - Fax:920-727-4956
Practice Address - Street 1:1540 LYON DR
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-5069
Practice Address - Country:US
Practice Address - Phone:920-727-4946
Practice Address - Fax:920-727-4956
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37832207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32229200Medicaid
WI000071580Medicare PIN
WIF96046Medicare UPIN