Individual
EMMANUEL OLAWUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 457-4461
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
81681
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002366008
—
WI
Enumeration date
04/09/2020
Last updated
05/30/2023
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