Individual
OLUBUKOLA DAVID BOLAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 396-5292
(703) 396-5297
Mailing address
7726 GUNSTON PLZ UNIT 1164, LORTON, VA 22199-8054
(817) 773-7014
(844) 373-1885
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101261217
VA
207R00000X
Internal Medicine Physician
M3919
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0284562
—
OH
05
—
180925301
—
TX
01
—
5461151
AETNA
TX
01
—
8P5794
BCBS
TX
Enumeration date
06/17/2005
Last updated
05/18/2023
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