Healthcare Provider Details

I. General information

NPI: 1912834979
Provider Name (Legal Business Name): CHARLENE SIMILOLUWA ABIDUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLENE SIMILOLUWA OMEKWU M.D.

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MISSISSIPPI MEDICAL CENTER 2500 NORTH STATE STREET
JACKSON MS
39216
US

IV. Provider business mailing address

ALL SAINTS UNIVERSITY, SCHOOL OF MEDICINE, HILLSBOROUGH
ROSEAU ST. GEORGE
00152
DM

V. Phone/Fax

Practice location:
  • Phone: 767-245-4631
  • 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: