Healthcare Provider Details

I. General information

NPI: 1831958651
Provider Name (Legal Business Name): OLUWATIMILEHIN OLUWASEGUN OGUNSINA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

582 BROCKHAMPTON LN UNIT 302
WESTERVILLE OH
43082-7556
US

IV. Provider business mailing address

582 BROCKHAMPTON LN UNIT 302
WESTERVILLE OH
43082-7556
US

V. Phone/Fax

Practice location:
  • Phone: 740-689-7917
  • Fax:
Mailing address:
  • Phone: 740-689-7917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: