Provider Demographics
NPI:1801216429
Name:ODUNSI, OLUWATOSIN
Entity Type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:
Last Name:ODUNSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLUWATOSIN
Other - Middle Name:
Other - Last Name:ODUNSI-AKANJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1591 E MATISSE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9834
Mailing Address - Country:US
Mailing Address - Phone:716-994-6457
Mailing Address - Fax:
Practice Address - Street 1:1591 E MATISSE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9834
Practice Address - Country:US
Practice Address - Phone:716-994-6457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAMD61005429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program