Healthcare Provider Details

I. General information

NPI: 1144853359
Provider Name (Legal Business Name): MR. OLUFEMI F OBADELE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2020
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 CONCORD PIKE STE B
WILMINGTON DE
19803-1733
US

IV. Provider business mailing address

3906 CONCORD PIKE STE B
WILMINGTON DE
19803-1733
US

V. Phone/Fax

Practice location:
  • Phone: 302-689-3367
  • Fax: 302-536-2188
Mailing address:
  • Phone: 302-689-3367
  • Fax: 302-536-2188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: