MR. OLUKAYODE ADE ODUWOLE (NPI# 1306984711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306984711 |
| Entity Type | Individual |
| Full Name | MR. OLUKAYODE ADE ODUWOLE |
| Credential | PA |
| Practice Address |
20755 Greenfield Rd Suite #203 Southfield MI 48075-5403 |
| Mailing Address |
19871 Northbrook Dr Suite #203 Southfield MI 48076-5053 |
| Practice Telephone | 2483952206 |
| Practice Fax Number | 2483950456 |
| Mailing Telephone | 2483952206 |
| Mailing Fax Number | 2483950456 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2016-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601002421 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
20755 GREENFIELD RD SUITE #203 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053310128 | Laz Medical Group PC | Family Medicine | 20755 Greenfield Rd, #1101, Southfield, MI 48075-5403 | 2005-07-20 |
| 1316467319 | Enlightened Medical Home Visit Pllc | Clinic/Center | 20755 Greenfield Rd, Suite 803, Southfield, MI 48075 | 2017-06-21 |
| 1245764737 | Sharon Blackshire-tubie | Nurse Practitioner | 20755 Greenfield Rd, #203, Southfield, MI 48075-5403 | 2017-04-12 |
| 1487198255 | Monique R Clark | Nurse Practitioner | 20755 Greenfield Rd, Suite 100, Southfield, MI 48075-5403 | 2016-12-13 |
| 1376094268 | Therahealth Physio Therapy | Preferred Provider Organization | 20755 Greenfield Rd, Suite 602, Southfield, MI 48075-5403 | 2016-10-17 |
| 1528518511 | Progressive Rehab Services, Inc. | Clinic/Center | 20755 Greenfield Rd, Ste 200, Southfield, MI 48075-5403 | 2016-10-13 |
| 1265982466 | Uche Obua | Nurse Practitioner | 20755 Greenfield Rd, Southfield, MI 48075-5403 | 2016-10-12 |
| 1831543768 | Metro Mobility, LLC | Non-emergency Medical Transport (VAN) | 20755 Greenfield Rd, Ste 810, Southfield, MI 48075 | 2016-04-18 |
| 1992183875 | Mobility Home Health Care Inc | Home Health | 20755 Greenfield Rd, Suite 202, Southfield, MI 48075-5403 | 2015-05-12 |
| 1114330966 | Kinetix Rehab Services, Inc. | Clinic/Center | 20755 Greenfield Rd, Southfield, MI 48075-5403 | 2014-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144457706 | Kimberly Lynn Cosbey | Physician Assistant | 29829 Telegraph Rd Ste 200, Southfield, MI 48034-7656 | 2009-06-22 |
| 1225057664 | Lindsay Kathryn Brown | Physician Assistant | 17515 W 9 Mile Rd Ste 340, Southfield, MI 48075-4426 | 2006-07-18 |
| 1790766509 | John Kay Nwadinobi | Physician Assistant | 29610 Southfield Rd, Ste 250, Southfield, MI 48076-2000 | 2005-11-09 |
| 1053976951 | Rafik E Mansour | Physician Assistant | 23832 Southfield Rd, Southfield, MI 48075-8000 | 2019-05-06 |
| 1316455215 | Melissa Courtney Gasiorek | Physician Assistant | 22250 Providence Dr Ste 705, Southfield, MI 48075-6215 | 2018-01-14 |
| 1023461134 | Miranda Leah Katty | Physician Assistant | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2016-07-14 |
| 1255781928 | Katherine Rambeau | Physician Assistant | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2016-06-14 |
| 1447629795 | Soham Trivedi | Physician Assistant | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-09-16 |
| 1235366162 | James Benjiman Burdette IIi | Physician Assistant | 23999 Northwestern Hwy, Suite # 110, Southfield, MI 48075-2578 | 2009-06-18 |
| 1447485180 | Michael Allen Greene | Physician Assistant | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2009-05-26 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on MR. OLUKAYODE ADE ODUWOLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.