Healthcare Provider Details

I. General information

NPI: 1215250295
Provider Name (Legal Business Name): SUNDAY DAMILOLA OGUNDE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 DR DB TODD JR BLVD
NASHVILLE TN
37208-3501
US

IV. Provider business mailing address

1005 DR DB TODD JR BLVD
NASHVILLE TN
37208-3501
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-6000
  • Fax:
Mailing address:
  • Phone: 615-327-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD447017
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number58941
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: