Provider Demographics
NPI:1285450205
Name:OJEWOLE, FOLUSO OLADAYO
Entity type:Individual
Prefix:DR
First Name:FOLUSO
Middle Name:OLADAYO
Last Name:OJEWOLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7235 WILSHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9327
Mailing Address - Country:US
Mailing Address - Phone:317-931-8361
Mailing Address - Fax:
Practice Address - Street 1:7235 WILSHIRE WAY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9327
Practice Address - Country:US
Practice Address - Phone:317-931-8361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28151977A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health