NPI Code Detail JSON Logo

1679594030 NPI number — OLUMUYIWA AKINNIYI OJEDIRAN MD

NPI Number: 1679594030
Health Care Provider/Practitioner: OLUMUYIWA AKINNIYI OJEDIRAN MD

Information about “1679594030” NPI (OLUMUYIWA AKINNIYI OJEDIRAN MD) exists in 1679594030 in HTML format HTML  |  1679594030 in plain Text format TXT  |  1679594030 in PDF (Portable Document Format) PDF  |  1679594030 in an XML format XML  formats.

NPI Number : 1679594030 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679594030",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OJEDIRAN",
    "FirstName": "OLUMUYIWA",
    "MiddleName": "AKINNIYI",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "734 S SYCAMORE STREET",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PETERSBURG",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23803",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-733-0111",
    "MailingAddressFaxNumber": "804-733-1176",
    "FirstLinePracticeLocationAddress": "734 SOUTH SYCAMORE STREET",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PETERSBURG",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23803",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-733-0111",
    "PracticeLocationAddressFaxNumber": "804-733-1176",
    "EnumerationDate": "07/21/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207R00000X",
        "TaxonomyName": "Internal Medicine Physician",
        "LicenseNumber": "0101233648",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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