Healthcare Provider Details

I. General information

NPI: 1215621966
Provider Name (Legal Business Name): OLUWAPELUMI OLUWOLE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date: 01/08/2024
Reactivation Date: 10/16/2025

III. Provider practice location address

550 N HILLSIDE ST
WICHITA KS
67214-4910
US

IV. Provider business mailing address

PO BOX 5183
DENVER CO
80217-5183
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-2000
  • Fax:
Mailing address:
  • Phone: 800-225-0953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-53357
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-53357
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: