Basic Information
| Provider Information | |||||||||
| NPI: | 1396902201 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAWODU | ||||||||
| FirstName: | OLUWATOBI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 BLUE PKWY | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641302807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169223166 | ||||||||
| FaxNumber: | 8164482937 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 N 12TH ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661025161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169227600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2008 | ||||||||
| LastUpdateDate: | 01/20/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 6942 | KS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.