Individual
DR. OLUBUNMI ABOSEDE OKANLAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7426
(574) 647-6780
Mailing address
51310 SHAMROCK HILLS DR, GRANGER, IN 46530-7821
(574) 532-6280
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01042229A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
01042229A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000370175
BCBS MEMORIAL CHILDRENS HOSPITAL
IN
05
—
200029310
—
IN
Enumeration date
11/02/2005
Last updated
03/05/2018
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