1912834979 NPI number — DR. CHARLENE SIMILOLUWA ABIDUN M.D.

Table of content: DR. CHARLENE SIMILOLUWA ABIDUN M.D. (NPI 1912834979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912834979 NPI number — DR. CHARLENE SIMILOLUWA ABIDUN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABIDUN
Provider First Name:
CHARLENE
Provider Middle Name:
SIMILOLUWA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OMEKWU
Provider Other First Name:
CHARLENE
Provider Other Middle Name:
SIMILOLUWA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912834979
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ALL SAINTS UNIVERSITY, SCHOOL OF MEDICINE, HILLSBOROUGH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEAU
Provider Business Mailing Address State Name:
ST. GEORGE
Provider Business Mailing Address Postal Code:
00152
Provider Business Mailing Address Country Code:
DM
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:
UNIVERSITY OF MISSISSIPPI MEDICAL CENTER
Provider Second Line Business Practice Location Address:
2500 NORTH STATE STREET
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
767-245-4631
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2026

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)