| Doctor Name: | DR. OLUBUSOLA BRIMMO |
| NPI Number: | 1346412426 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101244240 |
| Business Practice Address: | 1100 Virginia St Rm 4056 Columbia, MO - 652120001 |
| Business Phone Number: | 5738825731 |
| Business Fax Number: | |
| Mailing Address: | 1100 Virginia St Rm 4056, COLUMBIA |
| State: | MO |
| Postal Code: | 652120001 |
| Phone Number: | 5738825731 |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2008 |
| NPI Last Update Date: | 06/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101244240 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |