Provider Demographics
NPI:1639130800
Name:OJO, OLUREMI ADEBOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUREMI
Middle Name:ADEBOLA
Last Name:OJO
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 1:1920 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1849
Mailing Address - Country:US
Mailing Address - Phone:419-222-8200
Mailing Address - Fax:419-222-8800
Practice Address - Street 1:1920 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1849
Practice Address - Country:US
Practice Address - Phone:419-222-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-082972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2439516Medicaid
OH4116011Medicare ID - Type Unspecified
OHH51986Medicare UPIN