Individual
DR. ADEBOWALE OGUNSEYE OGUNTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
212959
NY
207RN0300X
Nephrology Physician
Primary
97988
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000025670
EXCELLUS PROVIDER NUMBER
NY
05
—
02076084
—
NY
Enumeration date
11/18/2005
Last updated
12/21/2023
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