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General NPI Number Information
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NPI Number | 1467413450
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Entity Type | Individual
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Provider Name | OLUMIDE A DANISA MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 40 DUKE MEDICINE CIR
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City | DURHAM
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State | NC
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Zip | 27710-4000
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Country | US
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Telephone | 919-618-2735
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Fax |
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Provider Business Mailing Address
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Address Line | 40 DUKE MEDICINE CIR
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City | DURHAM
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State | NC
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Zip | 27710-4000
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Country | US
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Telephone | 919-618-2735
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 2024-01972
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | G89015
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License Number State | CA
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