Individual
TIWALOLA OLUFUNKE OSUNFISAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1 FORD PL STE 1F, DETROIT, MI 48202-3450
(800) 653-6568
Mailing address
1 FORD PL STE 1F, DETROIT, MI 48202-3450
(313) 623-6024
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301501334
MI
2084P0800X
Psychiatry Physician
57017811
OH
Other
Enumeration date
08/16/2010
Last updated
03/30/2021
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