Odukoya, Olusegun Adesanya

Odukoya, Olusegun Adesanya is an individual health care provider with primary practice located at 11100 Euclid Ave , Cleveland OH 44106-1716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Odukoya, Olusegun Adesanya can be contacted via phone (216) 844-3944.

Contact Information

Primary practice address
11100 Euclid Ave Cleveland OH 44106-1716
Phone: (216) 844-3944
Fax: (216) 844-8974
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X TP891 Kentucky
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 4301093350 Michigan
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 35.120134 Ohio

Profile Details

NPI number 1235387416
LBN Legal business name Odukoya, Olusegun Adesanya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2008
Last updated Mar 17th, 2018 - about 6 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 1235387416 NPPES
Kentucky Other 000000637130 ANTHEM BCBS
Kentucky MEDICAID 7100104620 ANTHEM BCBS
Kentucky Other P00773148 ANTHEM BCBS
Kentucky Other 000000637135 ANTHEM BCBS
Kentucky MEDICAID 3009952 ANTHEM BCBS

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