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NPI Code Detail

MEDICARE: DAVID OLATUNBOSUN FOWOPE PMHNP

MEDICARE: DAVID OLATUNBOSUN FOWOPE PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner71016847AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871485359
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID OLATUNBOSUN FOWOPE PMHNP
Provider Business Mailing Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number :
Provider Business Practice Location Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2025
Last Update Date : 01/12/2026

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