Individual
OLUYEMISI JOKOTADE FATUNDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C51242
CA
208000000X
Pediatrics Physician
FTL 42897
TX
208000000X
Pediatrics Physician
Primary
N6289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C512420
—
CA
05
—
187039601
—
TX
01
—
187039602
CSHCN
TX
05
—
200133280 A
—
OK
05
—
55354751
—
NM
Enumeration date
07/12/2005
Last updated
04/12/2017
Update your record
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