Provider Demographics
NPI:1487643599
Name:TAIWO, OLAKUNLE O (MD)
Entity Type:Individual
Prefix:DR
First Name:OLAKUNLE
Middle Name:O
Last Name:TAIWO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1699 WASHINGTON RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1629
Mailing Address - Country:US
Mailing Address - Phone:412-831-3744
Mailing Address - Fax:412-831-5663
Practice Address - Street 1:118 S CENTER ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1507
Practice Address - Country:US
Practice Address - Phone:724-264-4303
Practice Address - Fax:724-264-4305
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2010-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD067051L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG86842Medicare UPIN