Agbetunsin, Caroline O

Agbetunsin, Caroline O is an individual health care provider with primary practice located at 7410 Delaware Ln Sea-Mar Community Health Center, Vancouvar WA 91664-1408. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Agbetunsin, Caroline O can be contacted via phone (360) 896-5128.

Contact Information

Primary practice address
7410 Delaware Ln Sea-Mar Community Health Center Vancouvar WA 91664-1408
Phone: (360) 896-5128
Fax: (360) 896-5179
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 11279 Nevada

Profile Details

NPI number 1740250836
LBN Legal business name Agbetunsin, Caroline O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Feb 13th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740250836 NPPES
Nevada MEDICAID 100504870
Nevada MEDICAID 100504867

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