Olumuyiwa Ojediran, M.D P.C

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

0101233648 Issued in VA

Legal business name

OLUMUYIWA OJEDIRAN, M.D P.C

Practice address

734 S Sycamore St
Petersburg, VA 23803-5817

Phone

(804) 733-0111

Fax

(804) 733-1176

NPI assigned

Nov 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Olumuyiwa Akinniyi Ojediran, M.DNPI 1679594030

Title

President

Phone

(804) 733-0111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olumuyiwa Akinniyi Ojediran, MD

  • Internal Medicine Physician
  • Petersburg, VA
  • NPI 1679594030
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1659552156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 S SYCAMORE ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035817",
            "telephone_number": "804-733-0111",
            "fax_number": "804-733-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 S SYCAMORE ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035817",
            "telephone_number": "804-733-0111",
            "fax_number": "804-733-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLUMUYIWA OJEDIRAN, M.D P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "OJEDIRAN",
        "authorized_official_first_name": "OLUMUYIWA",
        "authorized_official_middle_name": "AKINNIYI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-733-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "VA",
            "license": "0101233648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "465753",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olumuyiwa Akinniyi Ojediran, MD
• Eniola Adebayo Okelana, MD, FCCP
• Old Dominion Adult Day Care
• Old Dominion Adult Day Care
• Olde Towne Wellness LLC
• On Time Quality Care Management ,LLC
• Nina Thi Ong-Pham, PA
• Open Doors to Redefining Therapeutic and Consulting Services LLC
• Optimum in Home Care LLC
• Michelle D Owen, PHARMD

• Adolescent Medicine (Internal Medicine) Physician in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Adolescent Medicine (Internal Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.