Osinbowale, Olusegun O.

Osinbowale, Olusegun O. is an individual health care provider with primary practice located at 2799 W Grand Blvd , Detroit MI 48202-2608. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Osinbowale, Olusegun O. can be contacted via phone (919) 397-9772.

Contact Information

Primary practice address
2799 W Grand Blvd Detroit MI 48202-2608
Phone: (919) 397-9772
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35-0836040 Ohio
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD.202262 Louisiana
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 2016-01051 North Carolina
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4301119316 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301119316 Michigan

Profile Details

NPI number 1114065547
LBN Legal business name Osinbowale, Olusegun O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Mar 1st, 2023 - about 3 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 1114065547 NPPES
Louisiana MEDICAID 1313815
Louisiana MEDICAID 05559318
Louisiana MEDICAID 1114065547

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