Provider Demographics
NPI:1962934307
Name:OLUWASE, ADEOLA (MD)
Entity type:Individual
Prefix:DR
First Name:ADEOLA
Middle Name:
Last Name:OLUWASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ADEOLA
Other - Middle Name:
Other - Last Name:AWODELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:351 WELLESLEY TRADE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-5669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 WELLESLEY TRADE LN STE 100
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-5669
Practice Address - Country:US
Practice Address - Phone:919-576-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-03169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine