Provider Demographics
NPI:1063216034
Name:COOPER, OLUWATOSIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:OLUWATOSIN
Middle Name:
Last Name:COOPER
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:MISS
Other - First Name:OLUWATOSIN
Other - Middle Name:
Other - Last Name:ADEYEYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2615 PEACHTREE INDUSTRIAL BLVD STE J117
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-430-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program