Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 2016-01363 | NC |
Y | 207RI0011X | Interventional Cardiology | 2016-01363 | NC |
NPI | 1053524967 |
---|---|
Provider Name | Dr. Oluseun Olukayode Alli |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 25/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31807 | ALABAMA BOARD OF MEDICINE (01) | AL |
MT184901 | MED TRAINING NUMBER (01) | PA |