Provider Demographics
NPI:1891159083
Name:ODUYERU, OLUKEMI
Entity Type:Individual
Prefix:
First Name:OLUKEMI
Middle Name:
Last Name:ODUYERU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RAINER GENERAL SURGERY
Mailing Address - Street 2:1960 OGDEN STREET
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1114
Mailing Address - Country:US
Mailing Address - Phone:303-318-1585
Mailing Address - Fax:
Practice Address - Street 1:RAINER GENERAL SURGERY
Practice Address - Street 2:1960 OGDEN STREET
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-318-1585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program