Most Relevant Information
Provider Data
| NPI Number: | 1003549205 |
| Provider Name: | OLATUNDE KUPONIYI DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/05/2022 |
| Last Updated: | 07/05/2022 |
Provider Practice Location
5501 OLD YORK RD STE 1
PHILADELPHIA
PA
191413098
Practice Location Phone/Fax
| Phone: | 2154567890 |
| Fax: |
Provider Mailing Location
5501 OLD YORK RD STE 1
PHILADELPHIA
PA
191413098
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |