Individual
CONSTANCE OLATIDOYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1414 S 42ND ST, WILMINGTON, NC 28403-6818
(910) 350-1330
(910) 350-1330
Mailing address
PO BOX 3743, WILMINGTON, NC 28406-0743
(910) 350-1330
(910) 350-1330
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9901275
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891375J
—
NC
Enumeration date
12/11/2006
Last updated
07/08/2007
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