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Individual

DR. OLUMIDE OLUREMI OLUWABUSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D, MRCPSYCH

Contact information

Practice address
4641 ROOSEVELT BOULEVARD, SCATTERGOOD BLDG, SUITE E 218, DREXEL UNIVERSITY COLLEGE OF MEDICINE, FRIENDS HOSPITAL, PHILADELPHIA, PA 19124
(215) 831-4041
Mailing address
4641 ROOSEVELT BLVD ,SCATTERGOOD BUILDING, SUITE E 218, DREXEL UNIVERSITY COLLEGE OF MEDICINE FRIENDS HOSPITAL, PHILADELPHIA, PA 19124-2343
(215) 762-7000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD441059
PA
2084P0800X
Psychiatry Physician
Primary
MT190474
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD441059
PENNSYLVANIA STATE BOARD OF MEDICINE, M.D., PRACTICE LICENSE,
PA
01
MT190474
PENNSYLVANIA, MEDICAL TRAINING LICENCE
PA
Enumeration date
07/23/2009
Last updated
09/09/2010
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