Provider Demographics
NPI:1003800053
Name:DAWODU, SEGUN TOYIN (MD, JD, MBA, LLM, MS)
Entity type:Individual
Prefix:DR
First Name:SEGUN
Middle Name:TOYIN
Last Name:DAWODU
Suffix:
Gender:M
Credentials:MD, JD, MBA, LLM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:40 V TWIN DR
Practice Address - Street 2:SUITE 205
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7875
Practice Address - Country:US
Practice Address - Phone:717-339-2790
Practice Address - Fax:717-798-3162
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071276L208100000X, 208VP0014X, 2081P2900X, 2081S0010X
MDD56237208100000X, 2081P0004X, 2081P2900X, 2081S0010X, 208VP0014X
VA01012275452081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699631100Medicaid
MD67512780-01OtherCIGNA
VA102524OtherANTHEM BCBS
MDF216OtherBCBS
PA102996450Medicaid
MD7767187OtherAETNA
MD7767187OtherAETNA
MD67512780-01OtherCIGNA
MDH24132Medicare UPIN