MEDICARE: DR. OLAYINKA OLATOKUNBO OMITOWOJU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.069546	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164483327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLAYINKA OLATOKUNBO OMITOWOJU M.D.

Provider Business Mailing Address
First Line	:	920 W MARKET ST
Second Line	:	SUITE 210
City	:	LIMA
State	:	OH
Zip	:	45805-2773
Country	:	US
Telephone Number	:	419-229-3362
Fax Number	:	419-229-8258

Provider Business Practice Location Address
First Line	:	1005 BELLEFONTAINE AVE STE 345
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45804-2886
Country	:	US
Telephone Number	:	419-229-3362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	01/21/2025

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