Healthcare Provider Details

I. General information

NPI: 1639926900
Provider Name (Legal Business Name): OLUWAFIDAMILOJU FLOURISH ADESINA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date: 01/09/2025
Reactivation Date: 02/23/2026

III. Provider practice location address

2347 5TH AVE LATTERMAN FAMILY HEALTH CENTER- UPMC
MCKEESPORT PA
15132
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER-PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-673-5009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT231200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: