Healthcare Provider Details

I. General information

NPI: 1619841343
Provider Name (Legal Business Name): OLANREWAJU OLADAYO OGUNRINDE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: OLAOYE AFOLASHADE MD

II. Dates (important events)

Enumeration Date: 10/04/2025
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 SIX FORKS RD STE 201
RALEIGH NC
27609-8617
US

IV. Provider business mailing address

5710 SIX FORKS RD STE 201
RALEIGH NC
27609-8617
US

V. Phone/Fax

Practice location:
  • Phone: 919-985-0401
  • Fax:
Mailing address:
  • Phone: 919-985-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHC8112
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: