MR. FOLUSHO EVERTON OGUNFIDITIMI (NPI# 1730389198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730389198 |
| Entity Type | Individual |
| Full Name | MR. FOLUSHO EVERTON OGUNFIDITIMI |
| Credential | PA-C |
| Practice Address |
Henry Ford Health System 2799 West Grand Blvd. Detroit MI 48202 |
| Mailing Address |
3334 Goat Fell Ann Arbor MI 48108-2087 |
| Practice Telephone | 3139169971 |
| Practice Fax Number | 3139162086 |
| Mailing Telephone | 3139169971 |
| Mailing Fax Number | 3139162086 |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-07-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601003120 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BLVD. |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336147461 | Joseph Lawrence Lelli | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2005-07-12 |
| 1053794859 | Ali Malik | Podiatrist | Henry Ford Health System, 1 Ford Pl Ste 2e, Detroit, MI 48202 | 2015-06-30 |
| 1598897696 | Geoffrey S. Mwaungulu | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-03-12 |
| 1578606463 | Rebecca S. Lurcott | Ophthalmology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-14 |
| 1184767949 | Jan Rival | Internal Medicine | Henry Ford Health System, 3031 West Grand Blvd., Detroit, MI 48202 | 2007-02-14 |
| 1295875342 | Vinaya Vallabhaneni | Preventive Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-07 |
| 1699821157 | Morton B. Cash | Radiology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-26 |
| 1881748242 | Felix Umansky | Neurological Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| 1558415901 | Sidney Goldstein | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| 1205989753 | Shanthi Gopal | Family Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881822187 | Shea Mace | Physician Assistant | 6799 West Grand Blvd, Detroit, MI 48202 | 2009-06-24 |
| 1942469135 | Marcus Harris | Physician Assistant | 13949 Artesian St, Detroit, MI 48223-2915 | 2008-06-03 |
| 1316135379 | Clifford N Owhor | Physician Assistant | 4777 E Outer Dr Ste 1147, Detroit, MI 48234-3241 | 2007-10-04 |
| 1720513435 | Olivia Luisa Rojas | Physician Assistant | 2799 W Grand Blvd, Clinic K, 11th Floor, Detroit, MI 48202-2608 | 2017-05-01 |
| 1043760754 | Nicholas Joseph Michel | Physician Assistant | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2016-10-05 |
| 1013387174 | Sybrena Evans | Physician Assistant | 3901 Beaubien St, Detroit, MI 48201-2119 | 2015-10-01 |
| 1639574494 | Matthew Scott Mckay | Physician Assistant | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2014-10-22 |
| 1922348184 | Carleta Poydras | Physician Assistant | 6071 W Outer Dr, Joint Excel Plus Orthopedic Clinic, Detroit, MI 48235-2624 | 2013-02-26 |
| 1801162532 | Jodi Iacco | Physician Assistant | 22201 Moross Rd, Professional Building 1 Suite 132, Detroit, MI 48236-2169 | 2012-03-27 |
| Find all providers in DETROIT | ||||
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| 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.