Individual
OLAMIDE ODUBOGUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
618 CORNWALL RD, BUILDING 2, LEBANON, PA 17042-7089
(717) 279-6700
(717) 279-6759
Mailing address
PO BOX 300, LEBANON, PA 17042-0300
(717) 270-7780
(717) 274-9746
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD454061
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2012
Last updated
07/31/2015
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