Individual
OLAWALE O OLATUNJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
306 STANAFORD RD, BECKLEY, WV 25801-3142
(681) 207-2055
(681) 207-1811
Mailing address
803 SEMINOLE CIR, MOUNT HOPE, WV 25880-8811
(606) 224-1740
(681) 207-1811
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36772
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000584950
BCBS- CUMBERLAND CLINIC
—
01
—
26160
WV MEDICAL LICENSE
WV
05
—
64050230
—
KY
Enumeration date
03/14/2006
Last updated
04/21/2022
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