Active NPI
Mojisola Olufunmilayo Popoola, MD, MPH
- Anatomic Pathology & Clinical Pathology Physician
- Philadelphia, PA
National Provider Identifier
1821659384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MT218333
- Practice address
- 245 N 15TH St
Philadelphia, PA 19102-1198 - Phone
- (215) 762-1179
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MT218333 | PA | Primary |
Addresses
Primary practice location
245 N 15TH St
Philadelphia, PA 19102-1198
Mailing address
1501 City Ave
Wynnewood, PA 19096-3715
Phone (832) 909-2903
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT218333 | PA | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567296000000",
"number": "1821659384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 CITY AVE",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963715",
"telephone_number": "832-909-2903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 N 15TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021198",
"telephone_number": "215-762-1179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPOOLA",
"first_name": "MOJISOLA",
"middle_name": "OLUFUNMILAYO",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2019-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "PA",
"license": "MT218333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.