Healthcare Provider Details

I. General information

NPI: 1457147266
Provider Name (Legal Business Name): DAMILOLA MAUREEN OLOGBE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DRIVE, SUITE 4001 ACADEMIC INTERNAL MEDICINE CLINIC
YPSILANTI MI
48197
US

IV. Provider business mailing address

13 GRAFTON AVENUE WOODTHROPE
NOTTINGHAM NOTTINGHAMSHIRE
NG5 4GD
GB

V. Phone/Fax

Practice location:
  • Phone: 734-712-3980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: