Individual
DR. BABATUNDE ADEWALE OLATIDOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 362-9511
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
36869
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36869
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055N
BCBS OF NC
NC
01
—
220030424
RAILROAD MEDICARE
—
05
—
8964209
—
NC
05
—
Q36869
—
SC
Enumeration date
10/12/2005
Last updated
10/16/2018
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