Organization
OLUMUYIWA OJEDIRAN, M.D P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUMUYIWA AKINNIYI OJEDIRAN M.D (PRESIDENT)
(804) 733-0111
Entity
Organization
Contact information
Practice address
734 S SYCAMORE ST, PETERSBURG, VA 23803-5817
(804) 733-0111
(804) 733-1176
Mailing address
734 S SYCAMORE ST, PETERSBURG, VA 23803-5817
(804) 733-0111
(804) 733-1176
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
0101233648
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
465753
BLUE CROSS
VA
Enumeration date
11/26/2007
Last updated
11/26/2007
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