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General NPI Number Information
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NPI Number | 1881044972
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Entity Type | Individual
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Provider Name | GREGORY OLUTOSIN OGUNNOWO MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 225 SMITH AVE N STE 400
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City | SAINT PAUL
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State | MN
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Zip | 55102-2568
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Country | US
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Telephone | 651-290-0133
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Fax | 651-241-2910
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-5000
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 86087-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2019004690
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 80576
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2019004690
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 82004
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License Number State | CT
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