| Dr Babatunde Adewale Olatidoye, MD | |
|
2131 S 17th St, Wilmington, NC 28401-7407 | |
| (910) 362-9511 | |
| Not Available |
| Full Name | Dr Babatunde Adewale Olatidoye |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 2131 S 17th St, Wilmington, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063400133 | NPI | - | NPPES |
| 220030424 | Other | RAILROAD MEDICARE | |
| 8964209 | Medicaid | NC | |
| Q36869 | Medicaid | SC | |
| 1055N | Other | NC | BCBS OF NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZC0500X | Pathology - Cytopathology | 36869 (North Carolina) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 36869 (North Carolina) | Primary |
| Entity Name | Wilmington Pathology Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205809589 PECOS PAC ID: 2668369075 Enrollment ID: O20040301001141 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Babatunde Adewale Olatidoye, MD Po Box 20169, Roanoke, VA 24018-0506 Ph: () - | Dr Babatunde Adewale Olatidoye, MD 2131 S 17th St, Wilmington, NC 28401-7407 Ph: (910) 362-9511 |
Dr. Brian Charles Shiro, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1915 S 17th St, Suite 100, Wilmington, NC 28401 Phone: 910-362-9511 | |
Dr. Stephen P Olsen, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 | |
Gowd Shiva Nagaraj, MD Pathology Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 | |
Rachel Jester, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 | |
Dr. Katharine Liu, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-362-9511 | |
Dr. Philip Martin Barber, MBBS Pathology Medicare: Medicare Enrolled Practice Location: 2131 S 17th St, Wilmington, NC 28401 Phone: 910-343-7074 Fax: 910-343-7829 |