Provider Demographics
NPI:1508641762
Name:IDOWU, OLUFUNKE
Entity Type:Individual
Prefix:
First Name:OLUFUNKE
Middle Name:
Last Name:IDOWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 W ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4815
Mailing Address - Country:US
Mailing Address - Phone:202-232-6936
Mailing Address - Fax:
Practice Address - Street 1:1325 W ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4815
Practice Address - Country:US
Practice Address - Phone:120-232-9752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator