Individual
OLUYOMI O OLUSANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1060 S BISHOP AVE, ROLLA, MO 65401-4465
(573) 426-5900
(573) 426-4466
Mailing address
PO BOX 932051, KANSAS CITY, MO 64193-0001
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002009086
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208747204
—
MO
Enumeration date
05/12/2006
Last updated
04/24/2013
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