Basic Information
Provider Information
NPI: 1811417793
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AWE
FirstName: OLUFOLAKEMI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 55310
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352555310
CountryCode: US
TelephoneNumber: 2057319701
FaxNumber:  
Practice Location
Address1: 619 19TH ST S
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352491816
CountryCode: US
TelephoneNumber: 2059344011
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/22/2017
LastUpdateDate: 12/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000XMD.37920ALY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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