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Individual

DR. PAUL OLUWATOYIN ODUSANYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6308 8TH AVE, HOSPITALIST MANAGEMENT GROUP , UNITED HOSPITALS, KENOSHA, WI 53143-5031
(201) 238-5395
Mailing address
201 W 30TH ST, APARTMENT 107, BAYONNE, NJ 07002-1876
(120) 123-8539

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5488-20
WI
208M00000X
Hospitalist Physician
54880-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100012065
WI
Enumeration date
09/02/2010
Last updated
11/22/2021
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