Healthcare Provider Details

I. General information

NPI: 1477445237
Provider Name (Legal Business Name): OLUWATOSIN OLOGBE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 STOCKMEYER BLVD
WESTLAND MI
48186-9322
US

IV. Provider business mailing address

2081 STOCKMEYER BLVD
WESTLAND MI
48186-9322
US

V. Phone/Fax

Practice location:
  • Phone: 734-828-4039
  • Fax: 734-828-4039
Mailing address:
  • Phone: 734-828-4039
  • Fax: 734-828-4039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: