Individual
DR. OLUWASEUN BABALOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845-1714
(260) 425-6030
(260) 425-6028
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01062295A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000481191
ANTHEM BC/BS
IN
01
—
01062295A
MEDICAL LICENSING NUMBER
IN
01
—
20535
PHP
IN
Enumeration date
07/22/2006
Last updated
04/13/2023
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