Provider Demographics
NPI:1811181696
Name:SHOYINKA, SOSUNMOLU OPEMEMI (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:SOSUNMOLU
Middle Name:OPEMEMI
Last Name:SHOYINKA
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S WARNER RD STE 130
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2826
Mailing Address - Country:US
Mailing Address - Phone:610-400-4885
Mailing Address - Fax:610-273-5542
Practice Address - Street 1:150 S WARNER RD STE 130
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2826
Practice Address - Country:US
Practice Address - Phone:610-400-4885
Practice Address - Fax:610-273-5542
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND206932084P0800X
AZ618262084P0800X
MO20100140882084P0800X
MI43015007342084P0800X
PAMD4684582084P0800X
390200000X
KS04372112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1452360341Medicare PIN