Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT202124 | PA |
N | 208600000X | Surgeon | MT202124 | PA |
N | 208D00000X | General Practice Physician | MD452377 | PA |
NPI | 1003174384 |
---|---|
Provider Name | Oluyomi Obafemi |
First Address | Denver, CO 80204-4505 |
Second Address | Denver, CO 80204-4505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DR.0056983 | STATE LICENSE NUMBER (01) | CO |