Provider Demographics
NPI:1952533580
Name:OGUNSAKIN, AMIE YEWANDE (MD)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:YEWANDE
Last Name:OGUNSAKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMIE
Other - Middle Name:ADETOKUNBO
Other - Last Name:OLALEYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-7842
Mailing Address - Fax:319-353-7850
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-7842
Practice Address - Fax:319-353-7850
Is Sole Proprietor?:No
Enumeration Date:2009-08-15
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.120986207R00000X
IAMD-48477207R00000X, 207RE0101X
FLME137306207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101422700Medicaid