Individual
OLUTOPE FAKIYESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 NEWTOWN ROAD, WARMINSTER, PA 18974
(215) 441-6600
(215) 441-6891
Mailing address
1375 MCDIVITT DR, BLUE BELL, PA 19422-3357
(610) 524-1552
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD064023L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017956240005
—
PA
01
—
0532414000
PERSONAL CHOICE
PA
01
—
260048344
RAILROAD MEDICARE
PA
01
—
261126000
MIS
PA
Enumeration date
07/25/2006
Last updated
07/08/2007
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