Individual
OLUGBENGA TOKUNBO OKUSANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
834 WALNUT ST STE 650, PHILADELPHIA, PA 19107-5109
(215) 955-6996
Mailing address
1025 WALNUT ST STE 607, PHILADELPHIA, PA 19107-5001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MT195581
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD444177
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT195581
PA
Other
Enumeration date
05/28/2009
Last updated
08/11/2020
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