Healthcare Provider Details

I. General information

NPI: 1801216429
Provider Name (Legal Business Name): OLUWATOSIN O ODUNSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLUWATOSIN ODUNSI-AKANJI

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 E MATISSE DR
MIDDLETOWN DE
19709-9834
US

IV. Provider business mailing address

1591 E MATISSE DR
MIDDLETOWN DE
19709-9834
US

V. Phone/Fax

Practice location:
  • Phone: 716-994-6457
  • Fax:
Mailing address:
  • Phone: 716-994-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036159424
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number036159424
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD61005429
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: