Provider Demographics
NPI:1649420191
Name:LADIPO, OLANIRAN (MD)
Entity Type:Individual
Prefix:
First Name:OLANIRAN
Middle Name:
Last Name:LADIPO
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 1:2641 LOCKWOOD RD
Mailing Address - Street 2:# 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5020
Mailing Address - Country:US
Mailing Address - Phone:910-717-0276
Mailing Address - Fax:
Practice Address - Street 1:1638 OWEN DRIVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-615-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-21
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200900954207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine