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Individual
SHAMUSIDEEN OLAYIBO OGBULU
Active
Individual
SHAMUSIDEEN OLAYIBO OGBULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01065806A
IN
207R00000X
Internal Medicine Physician
2011-01350
NC
208M00000X
Hospitalist Physician
0101258916
VA
208M00000X
Hospitalist Physician
01065806A
IN
208M00000X
Hospitalist Physician
Primary
2011-01350
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000584350
ANTHEM PIN
IN
05
—
200913430
—
IN
05
—
5918627
—
NC
05
—
NC1486
—
SC
01
—
P00657204
RR MEDICARE PIN
IN
Enumeration date
09/08/2008
Last updated
08/23/2024
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