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Individual

DR. YETUNDE O BALOGUN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(267) 294-9265
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT200039
PA
2086S0129X
Vascular Surgery Physician
V8935
TX

Other

Enumeration date
09/21/2011
Last updated
03/24/2026
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