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NPI Code Detail

MEDICARE: SAMUEL OPEOLUWA KOLAWOLE MD

MEDICARE: SAMUEL OPEOLUWA KOLAWOLE MD
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
1207R00000XInternal Medicine PhysicianMT237319PA

General Provider Information

NPI Number : 1720929102
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL OPEOLUWA KOLAWOLE MD
Provider Business Mailing Address
First Line : 1700 ST LUKES BLVD
Second Line :
City : EASTON
State : PA
Zip : 18045-5670
Country : US
Telephone Number : 484-526-1000
Fax Number :
Provider Business Practice Location Address
First Line : 1700 ST LUKES BLVD
Second Line :
City : EASTON
State : PA
Zip : 18045-5670
Country : US
Telephone Number : 484-526-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2026
Last Update Date : 05/21/2026

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