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General NPI Number Information
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NPI Number | 1740573997
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Entity Type | Individual
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Provider Name | OLUBUSAYO OBAYAN M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 9015 MOUNTAIN RIDGE DR STE 200
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City | AUSTIN
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State | TX
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Zip | 78759-7303
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Country | US
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Telephone | 512-312-7552
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Fax | 512-714-4786
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Provider Business Mailing Address
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Address Line | 9015 MOUNTAIN RIDGE DR STE 200
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City | AUSTIN
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State | TX
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Zip | 78759-7303
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Country | US
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Telephone | 512-312-7552
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Fax | 512-714-4786
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LP02257
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | Q5053
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License Number State | TX
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