Individual provider · NPI-1

Raphael Adebusoye

Student in an Organized Health Care Education/Training Program · Oklahoma City, OK

NPI number1265789002
StatusActive
Last updated in NPPESAug 10, 2012

Details

NPI
1265789002
Entity type
Individual (NPI-1)
Name
Raphael Adebusoye
Sex
Male
Sole proprietor
No
Enumeration date
Aug 10, 2012
Last updated
Aug 10, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

5500 N Western Ave
Oklahoma City, OK 73118-4019

Phone 405-810-8677

Mailing address

2021 Alameda St
Apt. 314
Norman, OK 73071-2173

Phone 973-342-0418

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