Olatinwo, Omotayo Mutiat

Olatinwo, Omotayo Mutiat is an individual health care provider with primary practice located at Alexandria Va Health Care System 2495 Shreveport Highway, Pineville LA 71360. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Olatinwo, Omotayo Mutiat can be contacted via phone (318) 473-0010.

Contact Information

Primary practice address
Alexandria Va Health Care System 2495 Shreveport Highway Pineville LA 71360
Phone: (318) 473-0010
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 063279 Georgia
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MD.204261 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD.204261 Louisiana

Profile Details

NPI number 1417120395
LBN Legal business name Olatinwo, Omotayo Mutiat
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2008
Last updated Sep 13th, 2023 - about 2 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 1417120395 NPPES
Louisiana MEDICAID 2160818

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