Healthcare Provider Details

I. General information

NPI: 1194046375
Provider Name (Legal Business Name): OLUBUSOLA OGUNLADE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLUBUSOLA OGUNLADE M.D.

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 STANTON CHRISTIANA RD STE 304
NEWARK DE
19713-2135
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 302-691-3800
  • Fax: 302-778-2250
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD82160
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0011010
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: