Individual
OMOLARA O FAKUNLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6400 DUTCHMANS PKWY STE 345, LOUISVILLE, KY 40205-3370
(502) 587-6010
(502) 587-1314
Mailing address
100 E LIBERTY ST, SUITE 800, LOUISVILLE, KY 40202-1434
(502) 587-6010
(502) 587-1314
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
34516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64017924
—
KY
Enumeration date
06/09/2006
Last updated
01/23/2019
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