Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 0101041494 | VA |
N | 207V00000X | Obstetrician & Gynecologist | 0101041494 | VA |
NPI | 1346209830 |
---|---|
Provider Name | Olugbenga S. Oredein |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Chesapeake, VA 23320-5995 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7687648 | (05) | VA |
B62116 | (02) | VA |