Healthcare Provider Details

I. General information

NPI: 1194341131
Provider Name (Legal Business Name): ABDULBARIL OLADAPO OLAGUNJU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE NORTH CAMPUS CLINIC, SUITE C
TUCSON AZ
85719
US

IV. Provider business mailing address

1501 N CAMPBELL AVE PO BOX 245046
TUSCON AZ
85724
US

V. Phone/Fax

Practice location:
  • Phone: 602-344-5011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDR.0076744
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: