Individual
BUSOLA OYEBIMPE OGUNDIPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8001 BROADWAY STE 202, MERRILLVILLE, IN 46410-5546
(219) 736-8105
Mailing address
2610 WILLIAM DR, VALPARAISO, IN 46385-8182
(219) 707-5615
(219) 707-5619
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26021081A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100307990
—
IN
Enumeration date
11/17/2011
Last updated
11/17/2011
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