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General NPI Number Information
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NPI Number | 1477849628
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Entity Type | Individual
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Provider Name | OSAHON JOHN OBAKPOLOR MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 4727 FRIENDSHIP AVE STE 200
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City | PITTSBURGH
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State | PA
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Zip | 15224-1778
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Country | US
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Telephone | 412-235-5810
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Fax | 412-235-5890
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Provider Business Mailing Address
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Address Line | 4727 FRIENDSHIP AVE STE 200
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City | PITTSBURGH
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State | PA
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Zip | 15224-1778
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Country | US
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Telephone | 412-235-5810
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Fax | 412-235-5890
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD452334
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | U3970
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MD452334
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | U3970
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License Number State | TX
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