Provider Demographics
NPI:1205522133
Name:AKINADE, OMOTOLA NOFISAT (MD)
Entity type:Individual
Prefix:MRS
First Name:OMOTOLA
Middle Name:NOFISAT
Last Name:AKINADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:OMOTOLA
Other - Middle Name:NOFISAT
Other - Last Name:SHEKONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:745 WONDERLAND ROAD SOUTH
Mailing Address - Street 2:207 POSTAL CODE-N6K1M1
Mailing Address - City:LONDON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N6K1M1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 E MICHIGAN
Practice Address - Street 2:SUITE 245
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912
Practice Address - Country:US
Practice Address - Phone:517-364-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program