Individual
DR. OLUSOLA OGUNDIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 ROOSEVELT RD, VALPARAISO, IN 46383-0970
(219) 464-1620
(219) 477-4565
Mailing address
342 E 109TH AVE, CROWN POINT, IN 46307-8693
(219) 310-2550
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
10165962A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01065962A
LICENSE
IN
05
—
200922610
—
IN
01
—
36-110404
STATE LICENSE NUMBER
IL
Enumeration date
03/19/2007
Last updated
04/16/2021
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