Individual
DR. OLUWATOSIN OLADIPUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-1053
Mailing address
PO BOX 25137, DECATUR, IL 62525-5137
(800) 897-6169
(800) 897-6170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036-110320
IL
207L00000X
Anesthesiology Physician
Primary
93451
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036110320
BC OF IL
IL
05
—
036110320
—
IL
Enumeration date
01/05/2006
Last updated
11/02/2022
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