Provider Demographics
NPI:1720869027
Name:AWE, OPEOLUWA
Entity Type:Individual
Prefix:
First Name:OPEOLUWA
Middle Name:
Last Name:AWE
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 1:216 S SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-2432
Mailing Address - Country:US
Mailing Address - Phone:316-208-4898
Mailing Address - Fax:
Practice Address - Street 1:216 S SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-2432
Practice Address - Country:US
Practice Address - Phone:316-208-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing