Provider Demographics
NPI:1154760734
Name:AKINBORO, OLADIMEJI AKINOLA (MD, MPH)
Entity type:Individual
Prefix:
First Name:OLADIMEJI
Middle Name:AKINOLA
Last Name:AKINBORO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:820 HARRISON STREET
Mailing Address - Street 2:FGH BUILDING, 1ST FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:817-317-1540
Mailing Address - Fax:
Practice Address - Street 1:BOSTON MEDICAL CENTER, MOAKLEY BUILDING, 3RD FLOOR
Practice Address - Street 2:830 HARRISON AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-638-6428
Practice Address - Fax:617-414-1831
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28757207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine