Provider Demographics
NPI:1023695244
Name:BALDAUF-DEAN, OLUFUNLAYO (MD)
Entity type:Individual
Prefix:DR
First Name:OLUFUNLAYO
Middle Name:
Last Name:BALDAUF-DEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 ST FRANCIS BLVD STE 510
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3267
Mailing Address - Country:US
Mailing Address - Phone:804-423-5050
Mailing Address - Fax:804-423-5048
Practice Address - Street 1:13710 ST FRANCIS BLVD STE 510
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3267
Practice Address - Country:US
Practice Address - Phone:804-423-5050
Practice Address - Fax:804-423-5050
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine