Provider Demographics
NPI:1598962722
Name:OYETUNDE, OLASUNKANMI KOLAWOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:OLASUNKANMI
Middle Name:KOLAWOLE
Last Name:OYETUNDE
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 1:2274 FERN TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5124
Mailing Address - Country:US
Mailing Address - Phone:908-416-5766
Mailing Address - Fax:908-687-6820
Practice Address - Street 1:2274 FERN TER
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5124
Practice Address - Country:US
Practice Address - Phone:908-416-5766
Practice Address - Fax:908-687-6820
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61756207R00000X
NJ25MA08276200207R00000X
WI60778208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist