Provider Demographics
NPI:1275324949
Name:OLATUNJI, JOSEPH OLAWALE (DPM)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:OLAWALE
Last Name:OLATUNJI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:YUSUF
Other - Middle Name:OLAWALE
Other - Last Name:OLATUNJI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:213 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234-1557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:781-492-7681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program