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Individual

CLEMENT ADEDEJO OGUNWANDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1800 N. BROOM STREET, SUITE 109, WILMINGTON, DE 19802
(302) 762-4545
(302) 762-9086
Mailing address
1800 N. BROOM STREET, SUITE 109, WILMINGTON, DE 19802
(302) 762-4545
(302) 762-9086

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C2-0004996
DE
207Q00000X
Family Medicine Physician
Primary
C20004996
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000981603
DE
Enumeration date
10/02/2006
Last updated
12/22/2010
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