1194619726 NPI number — MR. OLUWATIMILEHIN OLATOMIWA OKEYA M.D.

Table of content: MR. OLUWATIMILEHIN OLATOMIWA OKEYA M.D. (NPI 1194619726)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194619726 NPI number — MR. OLUWATIMILEHIN OLATOMIWA OKEYA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OKEYA
Provider First Name:
OLUWATIMILEHIN
Provider Middle Name:
OLATOMIWA
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194619726
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ALLIKALU HOSTEL, BLOCK 6 COLLEGE OF MEDICINE
Provider Second Line Business Mailing Address:
UNIVERSITY OF LAGOS 101-ARABA MUSHIN
Provider Business Mailing Address City Name:
LAGOS
Provider Business Mailing Address State Name:
LAGOS
Provider Business Mailing Address Postal Code:
100254
Provider Business Mailing Address Country Code:
NG
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2799 W GRAND BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-916-1553
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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