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NPI Code Detail

MEDICARE: YETUNDE OLAJIDE

MEDICARE:   YETUNDE  OLAJIDE
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
1171M00000XCase Manager/Care CoordinatorOK

General Provider Information

NPI Number : 1871047803
Entity Type Code : Individual
Provider Name (Legal Business Name) : YETUNDE OLAJIDE
Provider Business Mailing Address
First Line : 3013 SW 130TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-2069
Country : US
Telephone Number : 405-476-9511
Fax Number : 405-607-4963
Provider Business Practice Location Address
First Line : 3013 SW 130TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-2069
Country : US
Telephone Number : 405-476-9511
Fax Number : 405-607-4963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 08/08/2016

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Directions to “ YETUNDE OLAJIDE ” Practice Location

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