Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. OMOTAYO MUTIAT OLATINWO, M.D.
ActiveDR. OMOTAYO MUTIAT OLATINWO, M.D. is a Gastroenterology healthcare provider located in PINEVILLE, Louisiana. NPI 1417120395 is currently active in the NPPES registry. Verify at CMS.
Gastroenterology · PINEVILLE, LA
Registration Details
- NPI Number
- 1417120395
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 10, 2008 (18.366832682349 yrs)
- Last Updated
- Sep 13, 2023
- Licenses
-
063279 (GA)MD.204261 (LA)MD.204261 (LA)
Practice Information
- Address
-
ALEXANDRIA VA HEALTH CARE SYSTEM2495 SHREVEPORT HIGHWAYPINEVILLE, LA, 71360Browse LA providers · Browse ZIP 71360
- Phone
- 3184730010
- Primary Specialty
-
Gastroenterology
207RG0300X
- Additional Specialty
- Gastroenterology
- Additional Specialty
- Internal Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.