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General NPI Number Information
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NPI Number | 1326338336
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Entity Type | Individual
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Provider Name | SUNDAY AYODEJI OLATUNDE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 111 MEDICAL PKWY FL 2
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City | CHESAPEAKE
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State | VA
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Zip | 23320-0302
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Country | US
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Telephone | 757-312-4047
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Fax | 803-376-5885
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Provider Business Mailing Address
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Address Line | 667 KINGSBOROUGH SQ STE 101
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4999
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Country | US
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Telephone | 757-842-4481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35.133773
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 88377
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License Number State | SC
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