MEDICARE: RONKE OLOWOJESIKU MD, MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	MD210012112	DC

General Provider Information

NPI Number	:	1275152472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONKE OLOWOJESIKU MD, MPH

Provider Business Mailing Address
First Line	:	3336 14TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2302
Country	:	US
Telephone Number	:	202-476-5580
Fax Number	:	202-476-7611

Provider Business Practice Location Address
First Line	:	3336 14TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2302
Country	:	US
Telephone Number	:	202-476-5580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	07/06/2023

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