Provider Demographics
NPI:1619407426
Name:OROKUNLE, SYDNEY L (MD)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:L
Last Name:OROKUNLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:L
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4611 CAMPUS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-9533
Mailing Address - Country:US
Mailing Address - Phone:989-839-3500
Mailing Address - Fax:
Practice Address - Street 1:4611 CAMPUS RIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-9533
Practice Address - Country:US
Practice Address - Phone:989-839-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301112855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine