Provider Demographics
NPI:1912190547
Name:AFOLABI-BROWN, OLUFUNKE OLUDOLAPO (MD)
Entity type:Individual
Prefix:
First Name:OLUFUNKE
Middle Name:OLUDOLAPO
Last Name:AFOLABI-BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:484-628-1324
Mailing Address - Fax:
Practice Address - Street 1:909 SUMNEYTOWN PIKE STE 205
Practice Address - Street 2:
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477-1011
Practice Address - Country:US
Practice Address - Phone:215-607-8297
Practice Address - Fax:215-258-8577
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4422112080S0012X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029396230001Medicaid
PA1029396230005Medicaid