NPI Code Detail JSON Logo

1760672554 NPI number — FATIMAH ADEBUKOLA OLORIEGBE MD

NPI Number: 1760672554
Health Care Provider/Practitioner: FATIMAH ADEBUKOLA OLORIEGBE MD

Information about “1760672554” NPI (FATIMAH ADEBUKOLA OLORIEGBE MD) exists in 1760672554 in HTML format HTML  |  1760672554 in plain Text format TXT  |  1760672554 in PDF (Portable Document Format) PDF  |  1760672554 in an XML format XML  formats.

NPI Number : 1760672554 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760672554",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OLORIEGBE",
    "FirstName": "FATIMAH",
    "MiddleName": "ADEBUKOLA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "AYINLA",
    "OtherFirstName": "FATIMAH",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "811 2ND ST SE STE A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LITTLE FALLS",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "56345-3558",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "320-631-7200",
    "MailingAddressFaxNumber": "206-320-5343",
    "FirstLinePracticeLocationAddress": "811 2ND ST SE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LITTLE FALLS",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "56345-3559",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "320-631-7200",
    "PracticeLocationAddressFaxNumber": "206-320-5343",
    "EnumerationDate": "07/27/2007",
    "LastUpdateDate": "07/21/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "036124213",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "125-053767",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "67108",
          "LicenseNumberStateCode": "MN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.