Individual provider Active NPI

Enitan O Sodiya, PHARMD

  • Pharmacist
  • Detroit, MI
National Provider Identifier
1609170026
Registry record updated Dec 28, 2010
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OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Jan 19, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032673 Issued in MI
Practice address
10652 Gratiot Ave
CVS #8283
Detroit, MI 48213-1200
Phone
(313) 571-0441
NPI assigned
Dec 28, 2010
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032673 MI Primary

Addresses

Primary practice location

10652 Gratiot Ave
CVS #8283
Detroit, MI 48213-1200

Mailing address

4221 Merriman Loop
Howell, MI 48843-5212
Phone (248) 935-1241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302032673MIMDPharmacist

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1609170026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 MERRIMAN LOOP",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488435212",
            "telephone_number": "248-935-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10652 GRATIOT AVE",
            "address_2": "CVS #8283",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131200",
            "telephone_number": "313-571-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODIYA",
        "first_name": "ENITAN",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.