| Doctor Name: | DR. OLATOKUNBO EFUNSAMI SOYODE-ETOMI |
| NPI Number: | 1326132804 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 9300327 |
| Business Practice Address: | 5420 Callander Ct. Charlotte, NC - 282775556 |
| Business Phone Number: | 7045427879 |
| Business Fax Number: | 7045430644 |
| Mailing Address: | 7221 Pinevile Matthews Rd, Suite 200 CHARLOTTE |
| State: | NC |
| Postal Code: | 282266176 |
| Phone Number: | 7044080744 |
| Fax Number: | 7045430644 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | 9300327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |